Multilobed neutrophils in a patient with heatstroke and amphetamine use
Multilobed neutrophils in a patient with heatstroke and amphetamine use
Heat stroke can cause neutrophils (PMNs) to become multilobed with a grape-like (botyroid) pattern. Panel A shows multilobed PMNs from a patient with heatstroke in the setting of amphetamine use. The white blood cell count was 17,800/microL, and 65 percent of PMNs showed the abnormality. Panel B shows the patient's monocytes, which demonstrate similar changes. Refer to the UpToDate topic on the peripheral blood smear for further information on this and other abnormal neutrophil findings.
PMN: polymorphonuclear neutrophil.
Reproduced with permission of the American Society of Hematology, from Nolte DA, Proytcheva MA. Flowers blossoming in the desert heat. Blood 2016; 128:2868; permission conveyed through Copyright Clearance Center, Inc.
