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The page below is a sample from the LabCE course White Cell and Platelet Disorders: Peripheral Blood Clues to Nonneoplastic Conditions. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Case Study One

Case Study One:
A 17-year-old female was admitted to the hospital with abdominal pain and a tentative diagnosis of appendicitis. The total white blood count was 14.5 X 109/L with a left shift along with neutrophils showing changes tagged by the arrow in the image (see blue arrow). The bluish-staining, blurred accumulations in the cytoplasm (Döhle bodies), are located at the cell periphery in neutrophils with toxic changes.
Döhle bodies are remnants of endocytoplasmic reticulum and are products of cytokine activity in the induction and shortened activity of neutrophil activation. They are often present in conditions with increased neutrophil lysosomal activity, manifest as toxic granulation.
In this case, the presence of Döhle bodies serves as markers for infection-induced leukocytosis and supports the diagnosis of acute appendicitis.