A morphologic variant of May-Hegglin anomaly in a Chinese girl

An 8 yr old Chinese girl was investigated for easy bruising and mild thrombocytopenia. Platelet aggregation studies and coagulation tests were found to be normal. The giant platelets and Döhle-like cytoplasmic inclusions in granulocytes confirmed the diagnosis of May-Hegglin anomaly. The father's granulocytes also had Döhle-like inclusions and one paternal aunt had a history of bleeding tendency. Review of literature showed that such Döhle-like inclusions had always been described morphologically as crescentic or spindle-shaped. In this case, however, the shape was roundish, oval or poorly defined. Ultrastructurally, the classic description was electron-dense long rods and needles orientating along the long axis of the "spindle". In this case, the only electron-dense particles were dot-like with a haphazard arrangement.