Background: White blood count is considered one of the important inflammatory markers, and its age and gender dependent, under unusual pathological conditions, which can lead to false elevation in TWBCs and should be corrected. Rare cases associated with severe hemolytic anemia and severe leukopenia have potential limitation when corrected using conventional formula.
Case presentation: A case report of 4 years old Sudanese boy patient who was hospitalized with sickle cell disease (SCD). Complete blood count (CBC) parameters were analyzed using 3PD Automated Hematology Analyzer. Peripheral blood picture (PBP) was prepared and stained using leishmen's stain. The data calculate using alternative formula as following. Corrected TWBCs = {mean white blood cells (HPF)/ mean NRBCs (HPF)} × TWBCs. The laboratory findings revealed TWBCs: 124×103/μL, PBP show one WBCs among each 30 NRBCs in ratio of 0.033, the corrected TWBCs: 4.09×103/μL. NRBCs: 119.9×103/μL.
Conclusion: The presence of NRBCs on ratio more than 1:1 NRBCs to WBCs must be calculated using an alternative formula for calculation of NRBCs and corrected TWBCs specially in cases of severe hemolytic anemia and megaloblastic anemia.
corrected TWBCs, NRBCs, alternative formula
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