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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]
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.
There are four types of granulocytes (full name polymorphonuclear granulocytes): [3] Basophils; Eosinophils; Neutrophils; Mast cells; Except for the mast cells, their names are derived from their staining characteristics; for example, the most abundant granulocyte is the neutrophil granulocyte, which has neutrally staining cytoplasmic granules.
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 ...
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.
The function of promyelocytes are closely linked to their differentiation into mature granulocytes, which include neutrophils, eosinophils, and basophils. [citation needed] These functions are essential for innate immunity and host defense mechanisms, including phagocytosis, inflammation, and immune surveillance.