Correspondt nce 397 CHI, T. (1984) Spattypre,aktionen auf Penicil- line sind dosisabhangig und korrelieren nicht mit medikamentenspexifischen Serumantikor- pern. (Abst.ract). Schwe-izerisch Mediziniscii~ Wochenschrift. 114, 11 78.

KEFTEL, K.A..HALJSER,S.€’.& MIIT.I.ER,M.R. (1985) Inhibition of granulopoiesis in vivo and in vitro by betalactam antibiotic>#. journal oj Infectious Diseases. 152 , 90-98.

PF,TZ, T,.D. & FUOENBEKG, 1i.H. (1966) Coombs positive haemolytic anaemia caused by penicil- lin administration. New EnglundJournal ofMedi- cine, 274, 171-178.

WHITE, J.M.. BROWN, D.L., HEPNER. G.W. 8 WORT.- I.EDGE, S.M. (1968) Penicillin-induced haemo- lytic anaemia. British Medical jourrurl, iii, 26- 29.

R I N G CELLS I N INFECTIOIJS MONONUCLEOSIS

Ring neutrophils occur in rodcnts and sporadi~ally in cats and dogs. In man, small numbers of these mysterious cells may occur in rnyeloproliferative disease (Langenhuisen, 1984) and in a patient with erythroleukaeniia (Stavem e t aI, 1969).

We have recently observed ring neutrophils in a patient with infectious mononucleosis, a 9-year-old girl with the classical clinical and hacmatological symptoms of the disease. In addition to characteristic ‘atypical’ mononuclear cells, five ring neutrophils were noted in a count of 200 band and segmented forms.

Work in rodents suggests thai thc size of the nuclear hole is related to the maturity of the cell, getting larger with iricreasing maturity. In our patient, the ring neutrophils and a large central hole which, together with their coarse chromatin, suggests that they were relatively mature (Fig 1).

Fig 1 .

398 Correspondence

Fig 2 .

It is of interest that we also observed typical glandular fever cells with a central hole among the typical cells of infectious mononucleosis (Fig 2). When the clinical symptoms improved, both kinds of cells had disappeared from the blood.

It is possible therefore that the appearance of these cells was provoked by the infection. Clearly, then, ring rieutrophils are not confined to haematological malignancy, but their general frequency remains unknown.

Department of’ Onco-Haernatologgt Research lnsti tute of Pediatrics, Medical Acadern y, 7 I ‘D. Nestorov’ St., Sofiu 1606. Bulgaria

REFERENCES

M. PEICHEV

LANGENHUIJSEN. M.M.A.C. (1984) Neutrophils HAGBN, C.B. (1969) Ring-shaped nuclei of granulocytes in patient with acute erythroleuk- aemia. Scandinavian journal of HaPmatology, 6,

with ring-shaped nuclei in myeloproliferative diseases. British journuf of Hmmatology, 58, 227-230. 31-32.

STAVEM, P.. HJORT, P.F., VOGT, E. & VAN DER