{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T06:04:23Z","timestamp":1769666663556,"version":"3.49.0"},"reference-count":8,"publisher":"Centre for Evaluation in Education and Science (CEON\/CEES)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/BY\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Biochemistry"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:p>We present a case of hemolytic disease of the newborn (HDN) due to maternal alloimmunisation with anti-E and anti-c antibodies, resulting in severe anaemia, respiratory insufficiency, and hyperbilirubinemia in a term male neonate. Haematological evaluation using the automated analyser Sysmex XN-3100 (Sysmex Corporation, Kobe, Japan) yielded an erroneously elevated white blood cell (WBC) count of 1 6 3 x 1 0 \/ L , later manually corrected to 2 8 x 1 0 \/ L due to extreme nucleated red blood cell (NRBC) interference (&amp;gt; 2,000 NRBCs per 100 WBCs). This case illustrates the analytical limitations of modern haematology analysers in neonates with pronounced erythroblastosis. It emphasises the essential role of manual peripheral blood smear review and interdisciplinary clinical-laboratory correlation in ensuring diagnostic accuracy.<\/jats:p>","DOI":"10.5937\/jomb0-60254","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T07:11:41Z","timestamp":1755069101000},"page":"217-219","source":"Crossref","is-referenced-by-count":0,"title":["Challenges in interpreting leukocyte and nucleated red blood cell counts in neonatal hemolytic disease: A case report on hematology analyser performance"],"prefix":"10.5937","volume":"45","author":[{"given":"Marina","family":"Jak\u0161i\u0107","sequence":"first","affiliation":[{"name":"Department of Laboratory Diagnostics, Institute for Children's Diseases, and Centre for Science, Clinical Centre of Montenegro, Podgorica, Montenegro"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6900-1608","authenticated-orcid":false,"given":"Lidija","family":"Banjac","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Institute for Children's Diseases, Clinical Centre of Montenegro, Podgorica, Montenegro"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boban","family":"Banjac","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, Clinical Centre of Montenegro, Podgorica, Montenegro"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3964","reference":[{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Babinszki A, Berkowitz RL. Haemolytic disease of the newborn caused by anti-c, anti-E and anti-Fya antibodies: report of five cases. Prenat Diagn 1999; 19(6): 533-6. doi: 10.1002\/(sici)1097-0223(199906)19:6<533:aid-pd570>3.0.co;2-5;","DOI":"10.1002\/(SICI)1097-0223(199906)19:6<533::AID-PD570>3.0.CO;2-5"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Chaudhary R, Elhence P Bharati JK, Srivastava A. A case report on non D HDFN: Highlighting the role of antibody screening in RhD positive antenatal women. Asian J Transfus Sci 2022; 16(1): 121-3. DOI: 10.4103\/ajts.ajts_108_21;","DOI":"10.4103\/ajts.ajts_108_21"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Christensen RD, Henry E, Jopling J, Wiedmeier SE. The CBC: reference ranges for neonates. NeoReviews 2010; 11(11): e620-e626. DOI: 10.1053\/j.semperi.2008.10.010;","DOI":"10.1053\/j.semperi.2008.10.010"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Gulati G, Uppal G, Gong J. Unreliable Automated Complete Blood Count Results: Causes, Recognition, and Resolution. Ann Lab Med 2022; 42(5): 515-30. DOI: 10.3343\/alm.2022.42.5.515;","DOI":"10.3343\/alm.2022.42.5.515"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Pikora K, Kr\u00e7towska Grunwald A, Krawczuk Rybak M, Sawicka Zukowska M. Diagnostic Value and Prognostic Significance of Nucleated Red Blood Cells (NRBCs) in Selected Medical Conditions. Cells 2023; 12(14): 1817. DOI: 10.3390\/cells12141817;","DOI":"10.3390\/cells12141817"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Stachon A, Sondermann N, Imohl M, Krieg M. Nucleated red blood cells indicate high risk of in hospital mortality. J Lab Clin Med 2002; 140(6): 407-12. DOI: 10.1067\/mlc.2002.129337;","DOI":"10.1067\/mlc.2002.129337"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Myle AK, Al Khattabi GH. Hemolytic Disease of the Newborn: A Review of Current Trends and Prospects. Pediatric Health Med Ther 2021; 12: 491-8. DOI 10.2147\/PHMTS327032;","DOI":"10.2147\/PHMT.S327032"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Li H, Tu Q, Feng K, Cheng J, Zou Z, Li S, Tan L. Nucleated red blood cells as a novel biomarker in the diagnosis and prediction of sepsis severity in children. Front Cell Infect Microbiol 2023; 13: 1264607. DOI: 10.3389\/fcimb.2023.1264607;","DOI":"10.3389\/fcimb.2023.1264607"}],"container-title":["Journal of Medical Biochemistry"],"original-title":["Izazovi u tuma\u010denju broja leukocita i nukleisanih eritrocita kod neonatalne hemoliti\u010dke bolesti - prikaz slu\u010daja o performansama hematolo\u0161kog analizatora"],"language":"en","link":[{"URL":"https:\/\/scindeks-clanci.ceon.rs\/data\/pdf\/1452-8258\/2026\/1452-82582601217J.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T17:56:23Z","timestamp":1769622983000},"score":1,"resource":{"primary":{"URL":"https:\/\/scindeks.ceon.rs\/Article.aspx?artid=1452-82582601217J"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":8,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.5937\/jomb0-60254","relation":{},"ISSN":["1452-8258","1452-8266"],"issn-type":[{"value":"1452-8258","type":"print"},{"value":"1452-8266","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]}}}