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Related Experiment Videos

Neutrophilic hypersegmentation without macrocytic anemia.

P G Hattersley, J L Engels

    The Western Journal of Medicine
    |September 1, 1974
    PubMed
    Summary

    Searching for hypersegmented neutrophils, even without enlarged red blood cells, is valuable. Many patients with this finding have folate or vitamin B-12 deficiencies, or are uremic.

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    Area of Science:

    • Hematology
    • Clinical Pathology

    Background:

    • Hypersegmented neutrophils can indicate various hematological conditions.
    • Erythroid macrocytosis is often associated with neutrophil hypersegmentation.

    Purpose of the Study:

    • To investigate the prevalence and significance of hypersegmented neutrophils in patients without erythroid macrocytosis.
    • To determine the underlying causes of hypersegmented neutrophils in this patient group.

    Main Methods:

    • Analysis of 25,000 blood smears from hospital and clinic patients.
    • Laboratory work-up for 200 patients with hypersegmented neutrophils and normal erythrocyte size.
    • Assessment for bacterial inhibitors, folate deficiency, vitamin B-12 deficiency, and renal failure (uremia).

    Main Results:

    • Seven patients had serum inhibitors affecting folic acid assays.
    • 45 out of 58 patients with normal B-12 levels showed folate or vitamin B-12 deficiency.
    • Seven patients were diagnosed with uremia, and 13 had no established deficiency.

    Conclusions:

    • Careful examination for hypersegmented neutrophils, irrespective of erythrocyte size, is clinically justified.
    • A significant proportion of patients with hypersegmented neutrophils have underlying folate/B-12 deficiencies or uremia.

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