Toxic granulation and unusually large platelets are symptoms of several different white blood cell disorders, according to the University of Virginia School of Medicine. The enlargement of platelets is most commonly associated with May-Hegglin anomaly, a result of altered RNA.
In addition to large platelets, May-Hegglin anomaly also presents with sizable basophilic inclusions that are pale in color. They look like L Dohle bodies, although they indicate an autosomal dominant anomaly. In addition to large platelets, thrombocytopenia also manifests with this disorder. While May-Hegglin is generally benign, it sometimes features bleeding disorders as well, notes the University of Virginia School of Medicine.
Chediak-Higashi syndrome presents with other platelet anomalies such as abnormal function and a lack of density in granules. With this syndrome, it's the melanosomes that are unusually large.
Toxic granulation appears in multiple white blood cell disorders that cause severe inflammation. These granules generally appear in the segmented, band, metamyelocyte and promyelocyte stages. As of 2015, the precise cause is unknown, but researchers believe it comes from a breakdown in the maturation of the cytoplasm. If L Dohle bodies appear (blue inclusions in the cytoplasm) with a disorder, toxic granulation often occurs as well, states the University of Virginia School of Medicine.