Intense stimulation of myelopoiesis causes toxic abnormalities in neutrophils to occur. These consist of coarser, reddish to blue-violet toxic granulations (corresponding to the primary granules of myeloid preliminary stages), basophilic inclusions also called Döhle bodies (corresponding to RNA remnants), and in cytoplasmic vacuoles. A shift to the left is also normally present at the same time. Myeloid precursors are often found in blood film which also show toxic abnormalities.
In monocytes, distinct vacuole formation is usually observed.
Toxic abnormalities in neutrophils and monocytes occur in infections (usually bacterial), in the recovery from myelosuppressive chemotherapy and following growth factor therapy such as granulocyte-colony stimulating factor (G-CSF). Pseudo-Döhle bodies are typically seen in the May-Hegglin anomaly.