Both nucleated RBCs and large platelets interfere with which of the following parameters?

Nucleated red blood cells (RBCs) and large platelets can indeed interfere with the white blood cell (WBC) count. This interference occurs because both nucleated RBCs and large platelets can be misidentified as white blood cells by automated counting instruments.

Nucleated RBCs, which may appear in peripheral blood during certain conditions such as bone marrow stress or regeneration, can be counted in the WBC differential unless specifically flagged or excluded by the analyzers. Similarly, large platelets may be counted alongside white blood cells due to their size and shape, leading to an overestimation of the total WBC count. This interference is particularly significant in patient populations where these cells are more prevalent, potentially skewing clinical interpretations and leading to misdiagnosis or inappropriate management.

The other parameters listed—hemoglobin, platelet count, and red blood cell count—are less directly affected by these components. Hemoglobin levels are generally measured as part of a different process and are less reliant on cell counts that include nucleated RBCs or large platelets. Platelet counts could potentially be affected but are more specifically targeted for measurement rather than being confused with WBCs. The red blood cell count primarily measures mature RBCs and would similarly