Importância da presença de granulações tóxicas para o diagnóstico hematológico de septicemia

Abstract

Importância da presença de granulações tóxicas para o diagnóstico hematológico de septicemia The investigation of the presence of toxic granulation for septicemia hematologic diagnostic

The importance of morphological changes in neutrophils in the diagnosis of bacterial infections in dogs with confirmed urinary tract infections in a Veterinary Care Service, Rio de Janeiro, Brazil

“…This reported information makes up the WBC, absolute cell numbers, rather than relative percentages, which can be misleading, should be used in interpreting the WBC response, and the individually specified WBC types should be determined, with the greatest number of cells counted and evaluated for a more reliable result, as the observation of direct stretches and smears of leukocyte concentrates from systemic blood has been useful to clarify the diagnosis and contribute to appropriate treatment ( Bastos et al, 2016 ; Lv et al, 2015 ; Papasouliotis & Murphy, 2021 ). On the other hand, the use of automation through hematology counters has not added any additional benefit, when used in a unique way ( Troìa et al, 2017 ), or provide quantitative information without complementary on the morphological characteristics of PMNs, monocytes and lymphocytes; thus not allowing, with the morphological evaluation, a more detailed examination and showing the need to detect which morphological variations, and therefore functional status , in response to stimuli, as in infections ( Oliveira-Costa et al, 2022 ; Paolino & Williams, 2021 ; Zhang et al, 2021 ), therefore, the special attention of neutrophils is necessary, as it is confirmed that the study of neutrophils presents an accuracy in the diagnosis of infection and sepsis greater than 98%, as observed at the present study, which brings the observation of neutrophilic changes in 100% of patients, as another important diagnostic parameter, since the neutrophil phenotype can potentially diagnose, monitor infection and sepsis ( Anderson & Singh, 2018 ; Ellett et al, 2018 ; Kim et al, 2009 ; Oliveira-Costa et al, 2022 ; Zhang et al, 2021 ) confirming the relationship between the presence of toxic alterations and microbiological infections confirmed by the isolation results ( Paolino & Williams, 2021 ; Salgado et al, 2007 ) as observed in the 10 case reports in the present study.…”

“…Nine out of 10 animals (90.0%) presented this abnormality ( Table 1 ), toxic granulations are small structures observed in the form of azurophilic granules or red-pink colored granules in the cytoplasm of neutrophils, due to the retention of mucopolysaccharide acid, which is normally lose in neutrophil maturation, appear as dispersed, small granules, commonly seen in cases of severe toxemia ( Ayres et al, 2019 ; Bastos et al, 2016 ; Buoro et al, 2018 ; Garland, 2011 ; Paolino & Williams, 2021 ; Yipp et al, 2017 ; Zhang et al, 2021 ) or they may present toxic manifestations through cytoplasmic basophilia, a change that appears in the grayish blue to dark blue coloration of the cytoplasm, present in bacterial infections associated with inflammation ( Garland, 2011 ), opposite to the normal neutrophil cytoplasm, and which can also manifest in young forms, where this basophilia is a result of retention of ribosomes and RER, due to accelerated granulopoiesis ( Polton, 2013 ; Thrall et al, 2012 ; Weiss & Wardrop, 2011 ). They may also result from endocytosis of toxic agents, with the formation of abnormal granules ( Salgado et al, 2007 ). The granules contain proteins that limit bacterial proliferation and confirm infection ( Al-Gwaiz & Babay, 2007 ; Oliveira-Costa et al, 2022 ).…”

Pathological profiles of systemic infections by Panton‐Valentine leukocidin‐positive, methicillin‐resistant Staphylococcus aureus strains in a murine model

“…In all animal groups, the presence of reactive lymphocytes after 24 h, and monocytes in 48 h, is suggestive of an intense immunological response to the pathogen. Both cells may cause cellular and tissue lesions, frequently observed during multiple organ failure associated with sepsis (Hokama and Machado 1997;Salgado et al 2007).…”

“…The presence of activated neutrophils is suggestive of disseminated destruction that occurs in severe inflammatory processes during the bacterial infections (Salgado et al 2007). The neutrophils observed in both BC01 PVL + and BC02 PVL + groups presented diverse aspects.…”

“…Bands were previously related to pro-inflammatory cytokines mediated bone marrow response (Hokama and Machado 1997). In some instances, granulocytes may present toxic granules, formed during endocytosis of bacterial toxic compounds and other specific inductors, and are associated with the damage of tissues (Salgado et al 2007). In all of the animal groups infected with PVL-positive strains, the neutrophils presented micronuclei and may represent a pattern of neutrophil damage associated with PVL-positive strains (Agostini 1993;Boyle-Vavra and Daum 2007;Ferraz et al 2016).…”