Diagnostic Value of Botryoid Nuclei as a Biomarker of Severe Hyperthermia and Systemic Inflammation in Heatstroke and Neuroleptic Malignant Syndrome: A Challenge of Climate Change

IF 2.3 4区医学 Q3 HEMATOLOGY

International Journal of Laboratory Hematology Pub Date : 2025-05-20 DOI:10.1111/ijlh.14500

Gonzalo Verdú, Marina Vallvé, Paula San-José, Angel Molina, Anna Merino

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引用次数: 0

Abstract

Introduction

With the increasing frequency of heat waves due to climate change, heat-related illnesses are becoming more common. Heatstroke is a life-threatening condition characterized by hyperthermia and multiple organ failure. A rare morphological feature, botryoid nuclei, has been identified in the peripheral blood of patients with hyperthermia, but its significance is not well understood. This study investigates the diagnostic value of botryoid neutrophils as a potential marker of severe hyperthermia and systemic inflammation in heatstroke and neuroleptic malignant syndrome.

Methods

We performed a retrospective analysis of six patients with hyperthermia who were admitted to the Hospital Clínic of Barcelona and the Hospital de la Santa Creu i Sant Pau during the summers of 2023 and 2024. Peripheral blood smears were analyzed using CellaVision DM9600, MC-80, and DI60 analyzers. Blood cell counts were obtained using Advia 2120i and Sysmex XN analyzers. Biochemical parameters were measured using Atellica Solutions and Alinity analyzers.

Results

Among the six cases, five were diagnosed with heatstroke and one with neuroleptic malignant syndrome. All patients exhibited botryoid nuclei in leucocytes (8% to 29%), more frequently observed in neutrophils. Hematologic findings included leucocytosis, neutrophilia with left shift, and thrombocytopenia. Biochemical analysis revealed significant organ dysfunction, including elevated liver enzymes, renal failure, and increased inflammatory markers, such as procalcitonin and lactic acid.

Conclusion

Botryoid-nuclei leucocytes may serve as a diagnostic marker for hyperthermia-related conditions, including heatstroke and neuroleptic malignant syndrome. This finding underscores the relevance of early recognition and intervention in patients presenting with hyperthermia and systemic inflammation.

查看原文本刊更多论文

在中暑和抗精神病药恶性综合征中，芽状体核作为严重高温和全身炎症的生物标志物的诊断价值：气候变化的挑战。

导读：由于气候变化，热浪越来越频繁，与热有关的疾病也越来越普遍。中暑是一种危及生命的疾病，其特征是体温过高和多器官衰竭。在高温患者的外周血中发现了一种罕见的形态特征，即芽状核，但其意义尚不清楚。本研究探讨了botrid中性粒细胞作为中暑和抗精神病药恶性综合征中严重高温和全身性炎症的潜在标志物的诊断价值。方法：回顾性分析2023年和2024年夏季在巴塞罗那Clínic医院和圣保罗圣克鲁医院收治的6例热疗患者。外周血涂片采用CellaVision DM9600、MC-80和DI60分析仪进行分析。使用Advia 2120i和Sysmex XN分析仪进行血细胞计数。使用Atellica Solutions和Alinity分析仪测定生化参数。结果：6例患者中，5例诊断为中暑，1例诊断为抗精神病药恶性综合征。所有患者白细胞（8% - 29%）中均出现botrloid核，中性粒细胞中更为常见。血液学表现包括白细胞增多、嗜中性粒细胞左移和血小板减少。生化分析显示明显的器官功能障碍，包括肝酶升高，肾功能衰竭，炎症标志物增加，如降钙素原和乳酸。结论：骨髓样核白细胞可作为高热相关疾病的诊断标志物，包括中暑和抗精神病药恶性综合征。这一发现强调了早期识别和干预出现高热和全身性炎症患者的相关性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Laboratory Hematology 医学-血液学

CiteScore

4.50

自引率

6.70%

发文量

211

审稿时长

6-12 weeks

期刊介绍： The International Journal of Laboratory Hematology provides a forum for the communication of new developments, research topics and the practice of laboratory haematology. The journal publishes invited reviews, full length original articles, and correspondence. The International Journal of Laboratory Hematology is the official journal of the International Society for Laboratory Hematology, which addresses the following sub-disciplines: cellular analysis, flow cytometry, haemostasis and thrombosis, molecular diagnostics, haematology informatics, haemoglobinopathies, point of care testing, standards and guidelines. The journal was launched in 2006 as the successor to Clinical and Laboratory Hematology, which was first published in 1979. An active and positive editorial policy ensures that work of a high scientific standard is reported, in order to bridge the gap between practical and academic aspects of laboratory haematology.