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Erythropoiesis01:14

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Red blood cells  (RBCs) transport oxygen to all body tissues. These cells survive only for 120 days and then need to be replenished. Erythropoiesis is the process of RBC production. In healthy individuals, erythropoiesis ensures all tissues are amply supplied with oxygen. In addition, blood loss due to injury leads to a drop in the physiological oxygen level that will cause erythropoiesis. Any defect in erythropoiesis leads to several physiological disorders, including thalassemia, anemia,...
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Circulating Nucleated Red Blood Cells: An Updated Reference Interval.

Amy A Meredith1, Neil R Meredith2, Lynelle Smith3

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Summary
This summary is machine-generated.

The upper limit for nucleated red blood cells (nRBCs) in healthy adults can be safely raised to 0.10 × 10^6/μL. This update to the reference interval reduces unnecessary patient anxiety and healthcare costs associated with abnormal findings.

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Area of Science:

  • Hematology
  • Clinical Pathology
  • Laboratory Medicine

Background:

  • Nucleated red blood cells (nRBCs) are typically absent in healthy adults, with traditional reference intervals (RIs) set very low.
  • Contemporary analyzers detect nRBCs at lower levels, leading to frequent abnormal flags in healthy individuals.
  • This has caused patient anxiety and increased referrals for further investigation.

Purpose of the Study:

  • To evaluate the clinical relevance of current reference intervals for nRBCs.
  • To determine if existing RIs for nRBCs accurately reflect the health status of non-hospitalized individuals.

Main Methods:

  • Prospective analysis of over 400,000 complete blood count (CBC) specimens.
  • Inclusion/exclusion criteria applied to create a study pool of 66,498 specimens from healthy, non-hospitalized individuals.
  • Analysis of nRBC counts in relation to established RIs.

Main Results:

  • 0.5% of healthy individuals (336 out of 66,498) had nRBC counts above the traditional RI of 0.01 × 10^6/μL.
  • Two samples showed nRBC counts greater than 0.10 × 10^6/μL.
  • No adverse outcomes were associated with these elevated nRBC counts in the study population.

Conclusions:

  • The upper limit of the nRBC reference interval can be safely updated to 0.10 × 10^6/μL.
  • Updating the RI will reduce unnecessary patient anxiety and decrease healthcare costs by minimizing superfluous follow-up testing.
  • This adjustment aligns laboratory findings with clinical reality for healthy populations.