Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA.
Veterinary Diagnostic Laboratory, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA.
Vet Clin Pathol. 2024 Jun;53(2):168-178. doi: 10.1111/vcp.13348. Epub 2024 Apr 3.
Lipofuscin-like cytoplasmic inclusions have been reported in human blood neutrophils and monocytes but have not been described in dogs. In people, these "green granules of death" have been associated with moderate to severe hepatocellular injury and high mortality.
To describe clinicopathologic abnormalities, diagnoses, and outcomes of dogs with greenish inclusions in blood neutrophils or monocytes, and to determine if the inclusions have features of lipofuscin.
Clinical cases were identified prospectively through routine evaluation of CBC samples. Leukocyte inclusions were characterized with routine staining and assessed for iron and autofluorescence. Additional cases were identified by examination of archived blood smears from dogs meeting search criteria for hepatocellular injury, and clinicopathologic findings were recorded.
All 7 prospectively identified dogs with inclusions had inflammation and moderate to marked increases in serum alanine aminotransferase (ALT) activity, as did the 4 dogs identified from the 97 meeting retrospective search criteria. The inclusions were Prussian blue-negative (5/5) with broad-spectrum autofluorescence (5/5) and the appearance of lipofuscin with and without Wright staining. Most clinical diagnoses involved hepatic disorders (5/7 prospective and 3/4 retrospective cases) or pancreatitis (3/7 prospective and 2/4 retrospective cases), and some involved both; 8 of 11 dogs died within 7 days of admission.
Blue-green cytoplasmic inclusions uncommonly found in blood neutrophils ± monocytes of routine canine blood smears have stained and unstained properties of lipofuscin and suggest the presence of hepatocellular injury, often severe. Reporting these inclusions is recommended to guide clinical management.
已在人类血液中性粒细胞和单核细胞中报告了类脂褐素样细胞质内含物，但在犬中尚未描述。在人类中，这些“绿色死亡颗粒”与中重度肝细胞损伤和高死亡率相关。
描述具有血液中性粒细胞或单核细胞中绿色内含物的犬的临床病理学异常、诊断和结果，并确定这些内含物是否具有脂褐素的特征。
通过常规评估 CBC 样本前瞻性地确定临床病例。使用常规染色对白细胞内含物进行特征描述，并评估铁和自发荧光。通过检查符合肝细胞损伤搜索标准的存档血涂片来识别其他病例，并记录临床病理发现。
所有 7 例前瞻性确定的具有内含物的犬均有炎症和丙氨酸氨基转移酶（ALT）活性中度至显著升高，符合回顾性搜索标准的 97 例犬中的 4 例也是如此。这些内含物普鲁士蓝染色阴性（5/5），广谱自发荧光阳性（5/5），具有脂褐素的外观，无论是否使用 Wright 染色。大多数临床诊断涉及肝脏疾病（5/7 例前瞻性和 3/4 例回顾性病例）或胰腺炎（3/7 例前瞻性和 2/4 例回顾性病例），有些病例同时涉及两者；11 例犬中有 8 例在入院后 7 天内死亡。
在常规犬血涂片的血液中性粒细胞和/或单核细胞中罕见发现的蓝绿色细胞质内含物具有脂褐素的染色和未染色特性，表明存在肝细胞损伤，通常是严重的。建议报告这些内含物，以指导临床管理。
