#00064886

The peripheral blood smears made from EDTA-anticoagulated blood showed golden-yellow refractile crystals in the cytoplasm of neutrophils. Neutrophils also show shift to left with toxic changes.

•The crystals were mostly rectangular to rhomboid in shape (original magnification ×1000, Leishman stain) seen in neutrophils. a. Rectangular bilirubin crystals, b. Rhomboid bilirubin crystal, c. Toxic changes(vacuoles & toxic granules in neutrophil )

•Bilirubin crystals are occasionally seen in neutrophils from neonates and children with marked hyperbilirubinemia.

•These bilirubin crystals are more commonly found in septicemia than with hemolytic disease of the newborn.

• The crystal formation is believed to be an in vitro phenomenon because it is specific to blood samples collected in EDTA.