The following is a summary of “Morphological changes in white blood cells in systemic inflammatory response syndrome (SIRS) with and without sepsis: An observational study,” published in the June 2023 issue of the Family Medicine and Primary Care by Sharma et al.

This observational study aims to investigate the morphological changes of white blood cells in Systemic Inflammatory Response Syndrome (SIRS) patients with and without sepsis and to evaluate the predictive value of morphological changes in white blood cells. Patients 18 years or older with SIRS with sepsis or SIRS without sepsis were included, while those with hematological disorders or who were pregnant were excluded. About 52 SIRS patients with sepsis and 32 SIRS patients without sepsis were included in the study. 

A peripheral blood smear was produced from the blood drawn from a vein. In both cases of SIRS with and without sepsis, toxic granules, cytoplasmic vacuoles, and Dohle bodies were evaluated and compared with culture-positive sepsis and shock. The presence of toxic granules was substantially higher in the SIRS with sepsis group compared to the SIRS without sepsis group (55.8% vs. 12.5%; P<0.001), as were cytoplasmic vacuoles (30.8% vs. 6.3%; P=0.012) and Dohle bodies (17.3% vs. 0%; P = 0.012). 

In the subgroup analysis of sepsis patients, those with a positive blood culture (9%) were found to have a significantly higher proportion of toxic granules (100% vs. 51.1%; P=0.059), cytoplasmic vacuoles (40% vs. 29.8%; P=0.637), and Dohle bodies (40% vs. 14.2%; P=0.202). These differences, however, were not statistically significant. Patients with SIRS and sepsis were more likely to have neutrophils with toxic granules and cytoplasmic vacuoles than patients with SIRS without sepsis. Dohle bodies were only detected in patients with sepsis, not those with SIRS who did not.

Source: journals.lww.com/jfmpc/Fulltext/2023/06000/Morphological_changes_in_white_blood_cells_in.25.aspx