Neutrophils: Toxic Changes and Disorders

Toxic Changes

morphologic changes when neutrophil maturation in bone marrow is disrupted, which causes loss of granule and membrane integrity

5 Toxic Changes

cytoplasmic vacuoles, cytoplasmic basophils, Dohle bodies, toxic granules, and nuclear changes

Cytoplasmic Basophilia

from persistent ribosomes in cytoplasm, cytoplasm is a blueish color

Dohle Bodies

blue/gray, angular inclusions in cytoplasm, have retained RER

Toxic Granules

retained primary granules

Nuclear Changes

karyolysis and karyorrhexis = breakdown of nucleus

Why do Toxic Changes happen?

intense, localized, or systemic infections, sterile inflammation, drug toxicity, major bacterial infections

What species is Toxic Changes normally seen it?

cats that experience mild illness. More significant in dogs

Noting Toxic Changes

slight (+1), mild (+2), moderate (+3), severe (+4)

Noting Toxic Changes: Slight (+1)

Dohle bodies with or without cytoplasmic basophilia

Noting Toxic Changes: Mild (+2)

slight (+1) AND any degrees of cytoplasmic vacyolization

Noting Toxic Changes: Moderate (+3)

slight and mild AND nuclear changes

Noting Toxic Changes: Severe (+4)

slight, mild, moderate, AND all types of toxic changes with/without cytoplasmic granules

Smudge Cells

degenerative leukocytes that ruptured, not significant UNLESS in large #, can be artifact: too much pressure on prep of blood smear or old sample

Barr Body

found ONLY in FEMALES, a morphological expression of an inactive X chromosome, a projection off of the nucleus

Condensed Chromatin

dark purple inside the nucleus, can be seen on any WBCs

Pelger-huet anomaly

congenital inherited disorder, hyposegmented of ALL granulocyte nuclei. Common in AUSTRALIAN SHEPHERDS, resulting in skeletal abnormalities

Chediak-higashi syndrome Neutrophils

inherited disorder, large fused lysosomes w/ cytoplasm, can have bleeding disorders, and P usually have no symptoms but neutrophil function abnormal