This week’s case features a patient currently in the Intensive Care Unit (ICU) suffering from acute liver failure. The laboratory data and the resulting blood film provide a sobering look at the systemic impact of hepatic collapse.
The clinical context:
The patient's FBC reveals a somewhat complex picture:
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Hb: 67 g/L
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PLT: 41 x 109/L
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WBC: 8.1 x 109/L
While reviewing the blood film, the biomedical scientist noticed abnormalities in the red cells, but also interestingly some inclusions with the neutrophils.
The challenge:
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What are the inclusions within the neutrophils called? They are sometimes referred to by a particularly ominous nickname.
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In the context of liver failure, what does the presence of these inclusions signify for the patient's prognosis?
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Aside from the neutrophil findings, what red cell features can you see on the film?
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