23 July 2016 (Saturday) - Green Neutrophil Inclusions

Here’s something new to me. Two references on the matter – Pubmed  and Blood – both respected publications.

Apparently green neutrophil inclusions have been reported as a sign of impending patient death. In a series of twenty patients in whom green inclusions were identified in neutrophils or monocytes thirteen died within days of the detection of the inclusions.
A common feature to almost all patients was ischaemic or hypoxic hepatitis which, in fatal cases, was associated with lactic acidosis.

What are the inclusions?

Light and electron microscopy indicated that the inclusions were lipid-rich, probably derived from lipofuscin-like material released from necrotic liver parenchymal cells.

It is recommended that that the detection of green inclusions, referred to as 'critical green inclusions', is acknowledged and reported by laboratories and correlated with clinical findings.

I’ve never seen them…

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