{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T18:02:56Z","timestamp":1758045776782,"version":"3.44.0"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T00:00:00Z","timestamp":1747699200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Lab Hematology"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>With the increasing frequency of heat waves due to climate change, heat\u2010related illnesses are becoming more common. Heatstroke is a life\u2010threatening 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective analysis of six patients with hyperthermia who were admitted to the <jats:italic>Hospital Cl\u00ednic of Barcelona<\/jats:italic> and the <jats:italic>Hospital de la Santa Creu i Sant Pau<\/jats:italic> during the summers of 2023 and 2024. Peripheral blood smears were analyzed using CellaVision DM9600, MC\u201080, 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Botryoid\u2010nuclei leucocytes may serve as a diagnostic marker for hyperthermia\u2010related 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.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijlh.14500","type":"journal-article","created":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T07:31:41Z","timestamp":1747726301000},"page":"877-883","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["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"],"prefix":"10.1111","volume":"47","author":[{"given":"Gonzalo","family":"Verd\u00fa","sequence":"first","affiliation":[{"name":"Biochemistry and Molecular Genetics Department Core Laboratory, Biomedical Diagnostic Centre, Hospital Clinic  Barcelona 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