Howell-Jolly body-like inclusions in neutrophils.
نویسندگان
چکیده
A 40-year-old HIV-positive man was evaluated for fatigue, weakness, fever, and cough. He was not taking any medications. His blood count showed normocytic anemia, leukopenia, and thrombocytopenia (hemoglobin 85.0 g/L, mean corpuscular volume 99 fL, white blood cell count 1.9 109/L, platelets 50 109/L). His CD4 count was 0.05 109/L. Other laboratory tests showed normal B12, folate, thyroid, and liver function tests. Review of his peripheral blood smear revealed the presence of polychromasia, occasional schistocytes, acanthocytes, target cells, and elliptocytes. Several neutrophils showed dysgranulopoietic features that included discrete, basophilic cytoplasmic inclusions (Howell-Jolly body–like inclusions) and occasional hypersegmented cells. The patient refused having bone marrow aspiration and biopsy. Pancytopenia with dysplastic features is common in patients with HIV infection. However, other conditions that cause myelodysplasia, such as nutritional disturbances, myelodysplastic syndrome, and sequelae of chemotherapy or transplantation, must be considered. With HIV infections, the presence of detached nuclear fragments in the cytoplasm of neutrophils that bear a resemblance to the nuclear remnants of red cells known as Howell-Jolly bodies can be found. These unusual inclusions should be differentiated from other intracytoplasmic inclusions, such as those that may be seen in infections or in rare inherited disorders, for example, Chediak-Higashi syndrome.
منابع مشابه
Prevalence of Howell-Jolly body-like inclusions in HIV patients and their correlation with CD4 counts and HIV RNA viral load.
Previous reports have described the rare occurrence of detached nuclear fragments resembling Howell-Jolly bodies within neutrophils from HIV patients, organ-transplant recipients, and patients on immunosuppressive drugs. To date, their potential clinical significance is unknown, and pathologists tend to disregard their presence. Our study sought to find a correlation between these inclusions an...
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ورودعنوان ژورنال:
- Blood
دوره 114 14 شماره
صفحات -
تاریخ انتشار 2003