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POLYMORPHONUCLEAR LEUCOCYTE HYPERSEGMENTATION IN HEAT STROKE

Neftel & Muller (1981) reported the phenomenon of heat-induced radial segmentation of leucocyte nuclei in a patient who developed this phenomenon when she suffered central hyperthermia (temperature = 43°C) following cerebral haemorrhage. They were able to reproduce the hypersegmentation in vitro by incubating the leucocytes from patients with various inflammatory and infectious problems at 4 1 O C . They proposed that radial hypersegmentation was a non-specific reaction to infection, inflammation or a necrotizing process. We have observed radial hypersegmentation in patients who presented with heat stroke. Our definition of radial hypersegmentation was the same as that reported by Neftel & Muller. Our series of 1 2 patients presented during a heat wave with fevers of 4 1 5 O C or higher, sudden neurologic compromise which was usually reversible, and the absence of an infectious aetiology for their fever. Of the 1 2 patients, four had radial hypersegmentation (Fig 1). It was seen only in the polymorphonuclear leucocytes and not in the monocytes or lymphocytes. In two patients, 60% of the polymorphonuclear cells were hypersegmented (Fig 2 ) , while in the other two patients less than 20% were hypersegmented. None of these four patients had evidence of megaloblastic maturation as judged by red cell indices. The