{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T17:08:34Z","timestamp":1763831314585,"version":"3.40.5"},"reference-count":10,"publisher":"Walter de Gruyter GmbH","issue":"3","license":[{"start":{"date-parts":[[2022,7,7]],"date-time":"2022-07-07T00:00:00Z","timestamp":1657152000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,14]]},"abstract":"Abstract<\/jats:title>\n \n Objectives<\/jats:title>\n Blue-green, birefractory, poorly-defined, cytoplasmic inclusions in some types of leukocytes are an underdiagnosed finding, which composition and clinical significance is not well understood. Inclusions are only found on peripheral blood smear (PBS).<\/jats:p>\n <\/jats:sec>\n \n Case presentation<\/jats:title>\n We report the case of a male with a history of chronic disease (hypertension, obesity, dyslipidemia, and kidney failure) admitted to the emergency room (ER) with shortness of breath, who was later transferred to the intensive care unit (ICU). The patient had a torpid disease course and ultimately died of multiorgan failure, including severe liver failure. When his status exacerbated, these inclusions were observed on PBS in conjunction with liver enzyme abnormalities.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This case confirms that blue-green inclusions on PBS in cases of acute severe liver failure with concurrent lactic acidosis should be immediately reported to the medical team, since it is suggestive of critical status and poor prognosis.<\/jats:p>\n <\/jats:sec>","DOI":"10.1515\/almed-2022-0060","type":"journal-article","created":{"date-parts":[[2022,7,7]],"date-time":"2022-07-07T06:53:11Z","timestamp":1657176791000},"page":"295-298","source":"Crossref","is-referenced-by-count":5,"title":["Blue-green neutrophilic inclusion bodies with concurrent liver failure as a predictor of imminent death"],"prefix":"10.1515","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7824-7239","authenticated-orcid":false,"given":"Antonio Sierra","family":"Rivera","sequence":"first","affiliation":[{"name":"Servicio de An\u00e1lisis Cl\u00ednicos Consorcio Hospital General Universitario de Valencia , Valencia , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Garc\u00eda","family":"Valdelvira","sequence":"additional","affiliation":[{"name":"Servicio de An\u00e1lisis Cl\u00ednicos Hospital Universitario Doctor Peset , Valencia , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda A.","family":"Elia Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Servicio de An\u00e1lisis Cl\u00ednicos Consorcio Hospital General Universitario de Valencia , Valencia , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c1ngeles F\u00e9rez","family":"Mart\u00ed","sequence":"additional","affiliation":[{"name":"Servicio de An\u00e1lisis Cl\u00ednicos Consorcio Hospital General Universitario de Valencia , Valencia , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Goitzane Marcaida","family":"Benito","sequence":"additional","affiliation":[{"name":"Servicio de An\u00e1lisis Cl\u00ednicos Consorcio Hospital General Universitario de Valencia , Valencia , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2022,7,7]]},"reference":[{"key":"2023062110183694132_j_almed-2022-0060_ref_001","doi-asserted-by":"crossref","unstructured":"Vicente-Steijn, R, Tom\u00e9, A, Maduell, F, Xipell, M, Castro, P, Molina, A, et al.. Green inclusions in neutrophils: a critical finding that must be reported. Int J Lab Hematol 2020;42:e101\u20134.","DOI":"10.1111\/ijlh.13138"},{"key":"2023062110183694132_j_almed-2022-0060_ref_002","doi-asserted-by":"crossref","unstructured":"Gorup, T, Cohen, AT, Sybenga, AB, Rappaport, ES. Significance of green granules in neutrophils and monocytes. Proc (Bayl Univ Med Cent) 2017;31:94\u20136. https:\/\/doi.org\/10.1080\/08998280.2017.1391045.","DOI":"10.1080\/08998280.2017.1391045"},{"key":"2023062110183694132_j_almed-2022-0060_ref_003","doi-asserted-by":"crossref","unstructured":"Soos, MP, Heideman, C, Shumway, C, Cho, M, Woolf, A, Kumar, C. Blue-green neutrophilic inclusion bodies in the critically ill patient. Clin Case Rep 2019;7:1249\u201352. https:\/\/doi.org\/10.1002\/ccr3.2196.","DOI":"10.1002\/ccr3.2196"},{"key":"2023062110183694132_j_almed-2022-0060_ref_004","doi-asserted-by":"crossref","unstructured":"Hodgson, TO, Ruskova, A, Shugg, CJ, McCallum, VJ, Morison, IM. Green neutrophil and monocyte inclusions\u00a0\u2013 time to acknowledge and report. Br J Haematol 2015;170:229\u201335. https:\/\/doi.org\/10.1111\/bjh.13434.","DOI":"10.1111\/bjh.13434"},{"key":"2023062110183694132_j_almed-2022-0060_ref_005","doi-asserted-by":"crossref","unstructured":"Patel, N, Hoffman, CM, Glodman, BI, Bentley, K, Burack, WR, Evans, AG. Green inclusions in neutrophils and monocytes are an indicator of acute liver injury and high mortality. Acta Haematol 2017;138:85\u201390. https:\/\/doi.org\/10.1159\/000477794.","DOI":"10.1159\/000477794"},{"key":"2023062110183694132_j_almed-2022-0060_ref_006","unstructured":"Haberichter, KL, Crisan, D. Green neutrophilic inclusions and acute hepatic failure: clinical significance and brief review of the literature. Ann Clin Lab Sci 2017;47:58\u201361."},{"key":"2023062110183694132_j_almed-2022-0060_ref_007","doi-asserted-by":"crossref","unstructured":"Courville, EL, Crisma, S, Linden, MA, Yohe, S. Green neutrophil inclusions are frequently associated with liver injury and may portend short-term mortality in critically ill patients. Lab Med 2017;48:18\u201323. https:\/\/doi.org\/10.1093\/labmed\/lmw064.","DOI":"10.1093\/labmed\/lmw064"},{"key":"2023062110183694132_j_almed-2022-0060_ref_008","doi-asserted-by":"crossref","unstructured":"Harris, VN, Malysz, J, Smith, MD. Green neutrophilic inclusions in liver disease. J Clin Pathol 2009;62:853\u20134. https:\/\/doi.org\/10.1136\/jcp.2009.064766.","DOI":"10.1136\/jcp.2009.064766"},{"key":"2023062110183694132_j_almed-2022-0060_ref_009","doi-asserted-by":"crossref","unstructured":"Cantu, MD, Towne, WS, Emmons, FN, Mostyka, M, Borczuk, A, Salvatore, SP, et al.. Clinical significance of blue-green neutrophil and monocyte cytoplasmic inclusions in SARS-CoV-2 positive critically ill patients. Br J Haematol 2020;190:e89\u201392. https:\/\/doi.org\/10.1111\/bjh.16882.","DOI":"10.1111\/bjh.16882"},{"key":"2023062110183694132_j_almed-2022-0060_ref_010","unstructured":"ASCLS, Hodgkins, SR, Jones, J. A case of blue-green neutrophil inclusions. Available from: https:\/\/ascls.org\/a-case-of-blue-green-neutrophil-inclusions\/. Fecha de consulta [Accessed 13 Oct 2022]."}],"container-title":["Advances in Laboratory Medicine \/ Avances en Medicina de Laboratorio"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/almed-2022-0060\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/almed-2022-0060\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,21]],"date-time":"2023-06-21T10:20:48Z","timestamp":1687342848000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/almed-2022-0060\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,7]]},"references-count":10,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,8,12]]},"published-print":{"date-parts":[[2022,10,14]]}},"alternative-id":["10.1515\/almed-2022-0060"],"URL":"https:\/\/doi.org\/10.1515\/almed-2022-0060","relation":{},"ISSN":["2628-491X"],"issn-type":[{"type":"electronic","value":"2628-491X"}],"subject":[],"published":{"date-parts":[[2022,7,7]]}}}