Immunofluorescence study of neutrophil NMMHC-IIA can be helpful for diagnosis of MHA in patients without leukocyte inclusion bodies. The life span of platelets is usually normal. The normal pattern of platelet aggregation and ATP secretion are seen in most cases of MHA.īleeding time is prolonged in proportion to the degree of thrombocytopenia. There is no evidence of dysplasia. The abnormal megakaryocytic fragmentation is believed to be the cause of the decreased platelet count. On electron microscopy, the platelets have abnormal lentiform shape due to the presence of increased amount of abnormally organized microtubules (parallel order of filaments in the inclusions).īoth the number and morphology of megakaryocytes are normal on bone marrow examination. In such cases, platelet count can be better estimated based on a careful morphologic evaluation of the peripheral blood smear. The presence of macrothrombocytes in some patients can often lead to underestimation of platelet count by automated analyzers. Platelets appear larger in size with the presence of large and giant forms. The inclusion bodies are not seen in platelets. The inclusions appear pale blue on Wright–Giemsa stain, are large and spindle shaped. Characteristic morphological findings of white blood cells and platelets are present on peripheral blood smear. Cytoplasmic inclusions resembling Dohle bodies are seen in neutrophils, but also in monocytes, eosinophils, and basophils. The platelet count ranges from 40–80 K/uL to normal values. Review of complete blood count (CBC) and careful evaluation of peripheral blood smear along with a detailed family history of bleeding diathesis are key for establishing the diagnosis of MHA.
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