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Along with Döhle bodies and toxic vacuolation, which are two other findings in the cytoplasm of granulocytes, toxic granulation is a peripheral blood film finding suggestive of an inflammatory process. [1] Toxic granulation is often found in patients with bacterial infection and sepsis, [1] [2] although the finding is nonspecific. [3]
Toxic vacuolation is associated with sepsis, particularly when accompanied by toxic granulation. [4] The finding is also associated with bacterial infection, [3] alcohol toxicity, liver failure, [4] and treatment with granulocyte colony-stimulating factor, a cytokine drug used to increase the absolute neutrophil count in patients with neutropenia.
If there are many neutrophils in the bloodstream containing Döhle bodies, these can be referred to as toxic neutrophils. Toxic neutrophils can also correspond to neutrophils that possess a more basophilic cytoplasm, basophilic granulation (infrequently observed), or cytoplasmic vacuoles in addition to one of the preceding cytoplasmic changes.
Qualitative abnormalities of white blood cells, like toxic granulation, are also visible on the blood smear. Modern complete blood count analyzers can provide an automated white blood cell differential, but they have a limited ability to differentiate immature and abnormal cells, so manual examination of the blood smear is frequently indicated.
Blood smear showing red blood cells with basophilic stippling. Basophilic stippling, also known as punctate basophilia, is the presence of numerous basophilic granules that are dispersed through the cytoplasm of erythrocytes in a peripheral blood smear.
A white blood cell differential is a medical laboratory test that provides information about the types and amounts of white blood cells in a person's blood. The test, which is usually ordered as part of a complete blood count (CBC), measures the amounts of the five normal white blood cell types – neutrophils, lymphocytes, monocytes, eosinophils and basophils – as well as abnormal cell ...
A food safety expert weighs in on flour bugs, also known as weevils, that can infest your pantry after one TikToker found her flour infested with the crawlers.
Pappenheimer bodies are visible with a Wright and/or Giemsa stain. Confirmation of non-heme iron in the granules is made with a Perls' Prussian blue stain, and this atypical red blood cell is then known as a siderocyte. [5]