There are a number of conditions in which hypersegmented neutrophils may be seen, such as megaloblastic anemias (including folic acid deficiency and. BMJ Case Rep. Aug 17; pii: bcr doi: /bcr Hypersegmented neutrophils and oval macrocytes in the setting of. Hypersegmented neutrophils and reversible hyperpigmentation in vitamin B12 deficiency in Ghana. Ivy Adwowa Efiefi Ekem.

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The patient in case 2, had hyperpigmentation, numbness and loss of reflexes, anaemia, macrocytosis and hypersegmented neutrophils: Hypersegmentation persists for an average of 14 days after institution of specific therapy. Clin Lab Med ; Views Beutrophils Edit View history.

Clinical chemistry Hematopathology Transfusion medicine Medical microbiology Diagnostic immunology Immunopathology Enzyme assay Mass spectrometry Chromatography Flow cytometry Blood bank Microbiological culture Serology.

She had difficulty in walking and felt numb in both feet.

In spite of the high serum vitamin B 12 value, the patient was anaemic, showed hypersegmented neutrophils, weakness and hyperpigmentation. In case 1, the patient was initially managed as suspected haemolytic anaemia and depression with folic acid and tryptizol. In this report, three cases of vitamin B 12 deficiency in Ghana are presented that highlight some important laboratory and clinical observations that may be helpful for hypersegmfnted in West Africa.

Intrinsic factor antibodies and vitamin B 12 metabolites have to be checked. Abnormal clinical and laboratory findings for blood tests R70—R79 In the diagnosis of megaloblastic anaemia, a thorough history and physical examination are essential.

A small percentage have four lobes, and occasionally five lobes may be seen. Articles which use infobox templates with no data rows. She had no medical history of note. Hypersegmentfd Viremia Fungemia Parasitemia Algaemia. Vitamin B 12 deficiency can present even in the face of high serum vitamin B 12 levels. Some of the most important pointers to vitamin B hyperseg,ented deficiency in Ghanaians and thus probably West Africans are hyperpigmentation, neutrophil hypersegmentation, macrocytosis and neurological signs hyperrsegmented symptoms.

Hypersegmented neutrophils and oval macrocytes in the setting of B12 deficiency and pancytopaenia.

Ivy Adwowa Efiefi Ekem. Case 1 was a year-old Ghanaian woman. The majority of neutrophils have three nuclear segments lobes connected by tapering chromatin strands. Vitamin B 12 cobalamin and folate deficiency constitute the commonest causes of megaloblastic anaemia.

Hypersegmented neutrophil – Wikipedia

Published online Sep Size Anisocytosis Macrocyte Microcyte. She had macrocytosis, occasional normoblasts and no hypersegmentation on her blood film.

She was continued on folic acid and steroids were added. It is visualized by drawing blood from a patient and viewing the blood smeared on a slide under a microscope. This led to a resolution of the dark urine colour and her Hb level improved to The patient in case 2 had the typical textbook description of vitamin B 12 deficiency. Elevated cardiac markers Elevated alpha-fetoprotein.

She was unemployed, lived with her father and had two children. Normal concentrations of vitamin B 12 have been seen in patients with overt deficiency, while high levels have been seen in functional deficiencies, implying that careful examination to identify other signs of the vitamin deficiency is important.


She presented with dark pigmentation of hands and feet, weakness and recurrent blackouts for 51 weeks. Megaloblastic anemia in North Africa. Work performed in North Africa 4 and Zimbabwe 5 did show a higher female to male ratio in the incidence of the disease.

By using this site, you agree to the Terms of Use and Privacy Policy. The serum vitamin B 12 estimation had been performed by the same laboratory using the same method of chemiluminescence assay, an automated non-isotopic no-boil assay. She readily responded to treatment accompanied by a hypersevmented of the hyperpigmentation, loss of her numbness, weakness and blackouts, a rise in Hb and normalisation of neutrophil segmentation.