The Association Between Cellular Morphological Changes in Peripheral Blood Smear and Complications in Pediatric Burn Cases

Abstract

Mortality and morbidity in burn cases can be reduced with early diagnosis. Many markers are used for early diagnosis of burn complications like sepsis. In this current study, the relationship between numerical/morphologic granulocyte abnormalities and complications was investigated in pediatric burns. It was aimed to introduce histopathologic marker(s) for burn-related complications. Thirty-two pediatric burn cases hospitalized between December 2006 and December 2009 were included in the study. A total of 192 complete blood count and peripheral blood smear results were analyzed comparatively. Findings were used to identify any correlation among white blood cell count and peripheral blood smear changes (the appearance of immature granular cells, toxic granulation, purple granules and Döhle bodies) and complications such as bacteriemia, sepsis, wound infections, severe anemia, and graft failure. White blood cell count changes and the appearance of immature granular cells were not suitable for use as a diagnostic marker for complications. Nevertheless, there was a statistically significant correlation between the appearance of toxic granulation, purple granules and Döhle bodies and subsequent complications (p: <0.0001, 0.041, 0.001, respectively). Toxic granulation, purple granules and Döhle bodies appear to be helpful in predicting burn-related complications. Therefore, peripheral blood smear is a suitable test for predicting future complications.