Figure 1.

Selected peripheral blood film findings on days 1 (A–G), 3 (H–L), 5 (M–N), and 40 (O). At presentation, neutrophils were hypersegmented (A), most with mild diffuse cytoplasmic basophilia, and red blood cells variously exhibited echinocytosis (A–F), increased Howell-Jolly bodies (B), metarubricytes (C), short to long rectangular hemoglobin crystals (D), basophilic stippling (E), mildly polychromatophilic elliptocytes (F), and polychromatophilic erythrocytes, most of which were similar in diameter to mature erythrocytes (G). On day 3, diffusely basophilic hypersegmented neutrophils without Döhle bodies persisted (H and L); there were also low numbers of blasts (I) and mostly monocytoid cells with increased diffuse cytoplasmic basophilia (J). Some cells had broad but rarely band-shaped nuclei and diffusely basophilic cytoplasm containing additional irregular patches of more intense basophilia (K). On day 5, hypersegmented neutrophils were more numerous (M and N). Throughout, some hypersegmented neutrophils were large (M). With recovery, circulating neutrophils appeared as in health, lacking cytoplasmic basophilia and hypersegmentation (O). The scale bar in frame O applies to all frames. Routine Romanowsky stains: Wright-Giemsa (A–G, M–O) and Modified Wright (H–L).