{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:20:58Z","timestamp":1787757658306,"version":"build-2784847793"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:p>\n                    Megakaryocytes are large cells with lobulated nuclei found within the bone marrow and comprising 0.01% of all nucleated cells. Circulating megakaryocytes in the peripheral blood smear (PBS) have been rarely described in the literature. We here report a case of a 41-year-old female presented with generalized weakness, high-grade fever (100.8\u00b0F), and nausea. Hematology laboratory reports showed anemia and leukocytosis (18.9 \u00d7 10\n                    <jats:sup>3<\/jats:sup>\n                    \/L) with a predominance of neutrophils (95%) and mature megakaryocytes in her PBS at the feathered edge. The laboratory findings of clinical chemistry revealed elevated urea, creatinine, and deranged liver function. This case highlights the rare occurrence of megakaryocytes in the PB of a patient suffering from systemic inflammatory response syndrome. The primary objective of the case study is to gain a better understanding of megakaryocyte biology and its role in the pathogenesis of systemic inflammatory responses.\n                  <\/jats:p>","DOI":"10.4103\/aam.aam_145_24","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T12:00:11Z","timestamp":1748606411000},"page":"696-698","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Circulating Megakaryocytes in a Peripheral Blood Smear at the Feathered Edge: An Incidental Finding in a Case of Systemic Inflammatory Response Syndrome"],"prefix":"10.4103","volume":"24","author":[{"given":"Anurag","family":"Singh","sequence":"first","affiliation":[{"name":"Department of Pathology, SGPGIMS, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akanksha","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Pathology, SGPGIMS, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ram Nawal","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Pathology, SGPGIMS, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,5,30]]},"reference":[{"key":"R1-20260422","first-page":"212","article-title":"Megakaryocytes in peripheral blood smears","volume":"36","author":"Garg","year":"2019","journal-title":"Turk J Haematol"},{"key":"R2-20260422","doi-asserted-by":"crossref","first-page":"2573","DOI":"10.1182\/blood-2017-08-803635","article-title":"Unusual finding of a megakaryocyte in a peripheral blood smear","volume":"130","author":"Ku","year":"2017","journal-title":"Blood"},{"key":"R3-20260422","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1007\/s12185-019-02752-5","article-title":"A megakaryocyte in a peripheral blood smear","volume":"110","author":"Nakai","year":"2019","journal-title":"Int J Hematol"},{"key":"R4-20260422","doi-asserted-by":"crossref","first-page":"53","DOI":"10.4103\/jcsr.jcsr_45_21","article-title":"Megakaryocyte in peripheral blood \u2013 Not always bad","volume":"11","author":"Konkay","year":"2022","journal-title":"J Clin Sci Res"},{"key":"R5-20260422","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1007\/s12185-020-02862-5","article-title":"Megakaryocytes in peripheral blood smears of non-hematological diseases","volume":"112","author":"Zhu","year":"2020","journal-title":"Int J Hematol"},{"key":"R6-20260422","doi-asserted-by":"crossref","first-page":"1288","DOI":"10.1161\/ATVBAHA.119.312129","article-title":"New insights into the differentiation of megakaryocytes from hematopoietic progenitors","volume":"39","author":"Noetzli","year":"2019","journal-title":"Arterioscler Thromb Vasc 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behaviors","volume":"14","author":"Frydman","year":"2023","journal-title":"Front Immunol"},{"key":"R11-20260422","doi-asserted-by":"crossref","first-page":"1507","DOI":"10.3390\/cells11091507","article-title":"Platelet versus megakaryocyte: Who is the real bandleader of thromboinflammation in sepsis?","volume":"11","author":"Garcia","year":"2022","journal-title":"Cells"},{"key":"R12-20260422","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1055\/s-0042-1757722","article-title":"Early and effective diagnosis of sepsis using flow cytometry","volume":"15","author":"Verma","year":"2023","journal-title":"J Lab Physicians"},{"key":"R13-20260422","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1182\/blood.V26.6.720.720","article-title":"Circulating megakaryocytes and platelet release in the lung","volume":"26","author":"Kaufman","year":"1965","journal-title":"Blood"},{"key":"R14-20260422","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1038\/nature21706","article-title":"The lung is a site of platelet biogenesis and a reservoir for haematopoietic progenitors","volume":"544","author":"Lefran\u00e7ais","year":"2017","journal-title":"Nature"},{"key":"R15-20260422","first-page":"137","article-title":"An unusual guest in a peripheral blood smear: Circulating endothelial cells as an artifact or an incidental finding?","volume":"5","author":"Singh","year":"2024","journal-title":"J Prim Care Spec"},{"key":"R16-20260422","doi-asserted-by":"crossref","first-page":"313","DOI":"10.32768\/abc.2024113313-316","article-title":"A follow-up case of breast carcinoma with the unusual visitor in peripheral blood: Unlock feathered edge secret: Breast carcinoma with unusual visitor in PBS","volume":"11","author":"Singh","year":"2024","journal-title":"Arch Breast Cancer"}],"container-title":["Annals of African Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_145_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:48:25Z","timestamp":1787755705000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_145_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,30]]},"references-count":16,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/aam.aam_145_24","relation":{},"ISSN":["1596-3519","0975-5764"],"issn-type":[{"value":"1596-3519","type":"print"},{"value":"0975-5764","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,30]]},"assertion":[{"value":"2024-08-07","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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