Basophilia

Case 1

Describe the CBC and differential

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Leukocytosis, macrocytic anemia, anisocytosis, neutrophilia, monocytosis, basophilia, left shift

What is the likely cause of the basophilia?

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CML

Let’s look at another example of basophilia in CML:

Case 2

Case 3

Describe the CBC and differential

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Leukocytosis, normocytic anemia, anisocytosis, neutrophilia, lymphocytosis, eosinophilia, monocytosis, basophilia, left shift

What is the likely cause of the basophilia?

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CMML

Case 4

Describe the CBC and differential

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Leukocytosis, polycythemia, microcytosis, anisocytosis, thrombocytosis, neutrophilia, monocytosis, basophilia

What is the likely cause of the basophilia?

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Polycythemia vera

Case 5

Describe the CBC and differential

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Microcytic hypochromic anemia, anisocytosis, thrombocytosis, basophilia

What is the likely cause of the basophilia?

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Iron deficiency anemia

Case 6

The data above are from a patient with ITP who received a 4 day course of dexamethasone 40 mg PO daily. Note that the glucocorticoid-induced leukocytosis is not associated with an increase in basophil count. In fact, some studies have shown that glucocorticoids reduce basophil counts.¹

Case 7

This is a case of a leukemoid reaction in a patient with septic shock. Note that the basophil count is low, not elevated!

Case 8

This patient has idiopathic eosinophilic syndrome. Note that the basophil count does not track with the eosinophil count.

References:

1. How I investigate basophilia in daily practice. Int J Lab Hematol. 2020 Jun;42(3):237-245.
2. Basophils in peripheral blood and bone marrow. A retrospective review. Am J Med 1984 Mar;76(3):509-11.