{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T18:11:35Z","timestamp":1789841495073,"version":"4.0.1"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Circulating plasmablasts and plasma cells are characteristic but underrecognized features of acute dengue virus (DENV) infection because of their transient nature. Their presence on peripheral blood smears may erroneously suggest a plasma cell dyscrasia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We report a case of secondary acute DENV serotype 3 infection in a 57-year-old traveler returning from the Caribbean that had morphologically suspected circulating plasma cells and thrombocytopenia, documented by peripheral blood smear and serial hematology analyzer scattergrams. Immunophenotypic confirmation was unavailable. We also performed a narrative review of published reports of plasmablast\/plasma cell kinetics in DENV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>An abnormal reactive lymphocyte scattergram with an increased very high-fluorescence cell signal prompted smear review, which revealed the abrupt appearance of reactive (activated) lymphocytes (25%) and suspected plasma cells (5%) on day 6 after symptom onset, coinciding with the platelet nadir, despite clinical improvement. Published reports have described circulating plasmablasts\/plasma cells from day 2, peaking around day 6, and disappearing by day 12, mirroring thrombocytopenia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Increased very high-fluorescence cell signal on the lymphocyte scattergram should prompt peripheral blood smear review to assess suspected plasmacytosis because high-fluorescence gating, although sensitive, is not definitive. In the appropriate context, circulating plasma cells with thrombocytopenia should raise suspicion of DENV rather than a plasma cell neoplasm. These cells\u2019 kinetics may represent a potential adjunctive, phase-related laboratory clue that requires prospective validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/labmed\/lmag064","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T11:33:40Z","timestamp":1787052820000},"source":"Crossref","is-referenced-by-count":0,"title":["Transient peripheral blood plasmacytosis and hematology analyzer scattergrams in acute dengue virus infection: case report with literature review"],"prefix":"10.1093","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0949-9708","authenticated-orcid":false,"given":"Florent","family":"Broussal","sequence":"first","affiliation":[{"name":"Laboratoire d\u2019H\u00e9matologie G\u00e9n\u00e9rale, H\u00f4pital Necker-Enfants malades (AP-HP, Universit\u00e9 Paris-Cit\u00e9) , Paris,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omer","family":"Beganovic","sequence":"additional","affiliation":[{"name":"Laboratoire d\u2019Onco-H\u00e9matologie, H\u00f4pital Necker-Enfants malades (AP-HP, Universit\u00e9 Paris-Cit\u00e9) , Paris,","place":["France"]},{"name":"INSERM UMR-S1151, CNRS UMR-S8253, Institut Necker Enfants Malades, Universit\u00e9 Paris Cit\u00e9 , Paris,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delphine","family":"Borgel","sequence":"additional","affiliation":[{"name":"Laboratoire d\u2019H\u00e9matologie G\u00e9n\u00e9rale, H\u00f4pital Necker-Enfants malades (AP-HP, Universit\u00e9 Paris-Cit\u00e9) , Paris,","place":["France"]},{"name":"H\u00e9mostase, Inflammation, Thrombose (HITh), UMR-S1176, INSERM, Universit\u00e9 Paris-Saclay , Le Kremlin-Bic\u00eatre,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Auditeau","sequence":"additional","affiliation":[{"name":"Laboratoire d\u2019H\u00e9matologie G\u00e9n\u00e9rale, H\u00f4pital Necker-Enfants malades (AP-HP, Universit\u00e9 Paris-Cit\u00e9) , Paris,","place":["France"]},{"name":"H\u00e9mostase, Inflammation, Thrombose (HITh), UMR-S1176, INSERM, Universit\u00e9 Paris-Saclay , Le Kremlin-Bic\u00eatre,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,19]]},"reference":[{"key":"2026091913491702300_lmag064-B1","doi-asserted-by":"publisher","first-page":"346","DOI":"10.1016\/j.jcrc.2017.11.003","article-title":"Dengue fever: report from the task force on tropical diseases by the World Federation of Societies of Intensive and Critical Care Medicine","volume":"43","author":"Amin","year":"2018","journal-title":"J Crit Care"},{"key":"2026091913491702300_lmag064-B2","doi-asserted-by":"publisher","first-page":"80","DOI":"10.4049\/jimmunol.1103350","article-title":"Association between magnitude of the virus-specific plasmablast response and disease severity in dengue patients","volume":"190","author":"Garcia-Bates","year":"2013","journal-title":"J Immunol"},{"key":"2026091913491702300_lmag064-B3","doi-asserted-by":"publisher","first-page":"e0143391","DOI":"10.1371\/journal.pone.0143391","article-title":"Dengue virus directly stimulates polyclonal B cell activation","volume":"10","author":"Correa","year":"2015","journal-title":"PLoS One"},{"key":"2026091913491702300_lmag064-B4","doi-asserted-by":"publisher","first-page":"1823","DOI":"10.1111\/j.1469-0691.2010.03434.x","article-title":"High incidence of peripheral blood plasmacytosis in patients with dengue virus infection","volume":"17","author":"Thai","year":"2011","journal-title":"Clin Microbiol Infect"},{"key":"2026091913491702300_lmag064-B5","doi-asserted-by":"publisher","first-page":"82","DOI":"10.3390\/cells10010082","article-title":"Usefulness of the New Hematological Parameter: Reactive Lymphocytes RE-LYMP with Flow Cytometry Markers of Inflammation in COVID-19","volume":"10","author":"Rutkowska","year":"2021","journal-title":"Cells"},{"key":"2026091913491702300_lmag064-B6","author":"Sysmex Xtra Online","year":"2011"},{"key":"2026091913491702300_lmag064-B7","doi-asserted-by":"publisher","first-page":"779","DOI":"10.1002\/jcla.21938","article-title":"Detection of apoptotic lymphocytes through Sysmex XN-1000 as a diagnostic marker for mononucleosis syndrome","volume":"30","author":"Sale","year":"2016","journal-title":"J Clin Lab Anal"},{"key":"2026091913491702300_lmag064-B8","doi-asserted-by":"publisher","first-page":"2202","DOI":"10.1182\/blood-2017-01-762500","article-title":"Plasmacytoid lymphocytes: a clue to dengue diagnosis","volume":"129","author":"Datta","year":"2017","journal-title":"Blood"},{"key":"2026091913491702300_lmag064-B9","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1093\/labmed\/lmy030","article-title":"Performance evaluation of high fluorescence lymphocyte count: comparability to atypical lymphocyte count and clinical significance","volume":"49","author":"Tantanate","year":"2018","journal-title":"Lab Med"},{"key":"2026091913491702300_lmag064-B10","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1002\/cyto.b.21350","article-title":"Utility of hematology analyzer and flow cytometry in timely and correct detection of circulating plasma cells: report of three cases","volume":"90","author":"Gounari","year":"2016","journal-title":"Cytometry Part B"},{"key":"2026091913491702300_lmag064-B11","doi-asserted-by":"publisher","first-page":"O156","DOI":"10.1111\/ijlh.13478","article-title":"High fluorescent lymphocyte cell count and scattergram patterns on the Sysmex XN series cell counters\u2014novel parameters in early and reliable diagnosis of dengue on a background of acute febrile illness","volume":"43","author":"Jayaram","year":"2021","journal-title":"Int J Lab Hematol"},{"key":"2026091913491702300_lmag064-B12","author":"Sant\u00e9 publique France","year":"2025"},{"key":"2026091913491702300_lmag064-B13","author":"Sant\u00e9 publique France","year":"2026"},{"key":"2026091913491702300_lmag064-B14","author":"World Health Organization","year":"2025"},{"key":"2026091913491702300_lmag064-B15","doi-asserted-by":"publisher","first-page":"911.e1","DOI":"10.1016\/j.amjmed.2006.12.011","article-title":"Diagnostic evaluation of mononucleosis-like illnesses","volume":"120","author":"Hurt","year":"2007","journal-title":"Am J Med"},{"key":"2026091913491702300_lmag064-B16","doi-asserted-by":"publisher","first-page":"e1568","DOI":"10.1371\/journal.pntd.0001568","article-title":"Dominant cross-reactive B cell response during secondary acute dengue virus infection in humans","volume":"6","author":"Zompi","year":"2012","journal-title":"PLoS Negl Trop Dis"},{"key":"2026091913491702300_lmag064-B17","doi-asserted-by":"publisher","first-page":"e29430","DOI":"10.1371\/journal.pone.0029430","article-title":"Dengue virus activates polyreactive, natural IgG B cells after primary and secondary infection","volume":"6","author":"Balakrishnan","year":"2011","journal-title":"PLoS One"},{"key":"2026091913491702300_lmag064-B18","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1016\/j.revmed.2012.03.357","article-title":"Plasmacytosis and dengue fever: an underestimated abnormality?","volume":"33","author":"G\u00e9r\u00f4me","year":"2012","journal-title":"La Revue de m\u00e9decine interne"},{"key":"2026091913491702300_lmag064-B19","doi-asserted-by":"publisher","first-page":"2911","DOI":"10.1128\/jvi.06075-11","article-title":"Rapid and massive virus-specific plasmablast responses during acute dengue virus infection in humans","volume":"86","author":"Wrammert","year":"2012","journal-title":"J Virol"},{"key":"2026091913491702300_lmag064-B20","doi-asserted-by":"publisher","first-page":"1080","DOI":"10.1002\/jha2.1011","article-title":"Circulating plasmablasts in dengue fever","volume":"5","author":"Noble","year":"2024","journal-title":"eJHaem"},{"key":"2026091913491702300_lmag064-B21","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1016\/j.revmed.2008.05.012","article-title":"Peripheral and bone marrow plasmacytosis in dengue fever: report of a case","volume":"30","author":"Bibi-Triki","year":"2009","journal-title":"La Revue de m\u00e9decine interne"},{"key":"2026091913491702300_lmag064-B22","doi-asserted-by":"publisher","first-page":"1026","DOI":"10.5858\/2003-127-1026-DFMPCL","article-title":"Dengue fever mimicking plasma cell leukemia","volume":"127","author":"Gawoski","year":"2003","journal-title":"Arch Pathol Lab Med"},{"key":"2026091913491702300_lmag064-B23","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/S1773-035X(06)80036-5","article-title":"Une plasmocytose au retour des tropiques","volume":"2006","author":"Vedy","year":"2006","journal-title":"Rev Francoph Lab"},{"key":"2026091913491702300_lmag064-B24","doi-asserted-by":"publisher","first-page":"e70272","DOI":"10.1111\/ped.70272","article-title":"Sequential appearance of two different types of atypical lymphocytes in dengue fever: a case report","volume":"67","author":"Nagashima","year":"2025","journal-title":"Pediatr Int"},{"key":"2026091913491702300_lmag064-B25","doi-asserted-by":"publisher","first-page":"2500","DOI":"10.3389\/fimmu.2019.02500","article-title":"Impaired antibody-independent immune response of B cells in patients with acute dengue infection","volume":"10","author":"Upasani","year":"2019","journal-title":"Front Immunol"},{"key":"2026091913491702300_lmag064-B26","doi-asserted-by":"publisher","first-page":"2291","DOI":"10.1111\/j.1538-7836.2007.02754.x","article-title":"Antiplatelet autoantibodies elicited by dengue virus non-structural protein 1 cause thrombocytopenia and mortality in mice","volume":"5","author":"Sun","year":"2007","journal-title":"J Thromb Haemost"}],"container-title":["Laboratory Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/labmed\/article-pdf\/57\/5\/lmag064\/71236238\/lmag064.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/labmed\/article-pdf\/57\/5\/lmag064\/71236238\/lmag064.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T17:49:21Z","timestamp":1789840161000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/labmed\/article\/doi\/10.1093\/labmed\/lmag064\/8818172"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,4]]},"references-count":26,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,8,4]]}},"URL":"https:\/\/doi.org\/10.1093\/labmed\/lmag064","relation":{},"ISSN":["0007-5027","1943-7730"],"issn-type":[{"value":"0007-5027","type":"print"},{"value":"1943-7730","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,9]]},"published":{"date-parts":[[2026,8,4]]},"article-number":"lmag064"}}