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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Case 3 had anorexia, hyperpigmentation, neurological defects and anaemia with hypersegmented neutrophils on the blood film.


Hypoglycemia Hyperglycemia Prediabetes Impaired fasting glucose Impaired glucose tolerance Oxyhyperglycemia.

Ivy Adwowa Efiefi Ekem, moc.

Support Center Support Center. Am J Hematol ; Case 1 was a year-old Ghanaian woman. Abstract The present report concerns three cases of vitamin B 12 deficiency in Ghana. She was a nurse with children and had undergone a hysterectomy 14 years previously for unclear reasons.

She had no medical history of note. American Journal of Clinical Pathology. Galloway M, Macrocytosis Hamilton M: Clinical chemistry Hematopathology Transfusion medicine Medical microbiology Diagnostic immunology Immunopathology Enzyme assay Mass spectrometry Chromatography Flow cytometry Blood bank Microbiological culture Serology.

Hypersegmented neutrophil – Wikipedia

It neutrophls suggested from the literature that the high serum vitamin B 12 may have been the result of high intrinsic factor antibodies.


Nuclear hypersegmentation of DNA in neutrophils strongly suggests megaloblastosis when associated with macro-ovalocytosis.

Surgical pathology Cytopathology Autopsy Molecular pathology Forensic pathology Oral and maxillofacial pathology Gross examination Histopathology Immunohistochemistry Electron microscopy Immunofluorescence Fluorescence in situ hybridization.

This is a clinical laboratory finding.

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The third patient presented with haemolytic anaemia with depression, and was managed as such initially. Hypersegmentation persists for an average of hypersegmente days after institution hypefsegmented specific therapy. Ivy Adwowa Efiefi Ekem. Some of the most important pointers to vitamin B 12 deficiency in Ghanaians and thus probably West Africans are hyperpigmentation, neutrophil hypersegmentation, macrocytosis and neurological signs and symptoms.

After diagnosis of vitamin B 12 deficiency intramuscular injections of vitamin B 12 1 mg hpersegmented a week were given over the first 3 weeks, then 1 mg every 3 months to be continued for life. Her joint pains persisted however, and nsutrophils also started experiencing numbness in her fingers and toes and a burning sensation in her right leg and left foot.

Hypersegmentation can sometimes be difficult to assert since interobserver variation is high, and important to note is that blacks have a greater neutrophil segmentation than whites [3] [4]. Diagnosis of cobalamin deficiency I: Hypersegmented neutrophil Medical diagnostics Blood smear with two hypersegmented neutrophils. Smudge cell Downey cell. Size Anisocytosis Macrocyte Microcyte. She responded well, with a normalisation of haemoglobin levels. Both responded well to treatment with vitamin B She had difficulty in walking and felt numb in both feet.


As to whether this is the general trend in the country or not, would be ascertained as we keep accumulating data. This led to a resolution of the dark urine colour and her Hb level improved to As to whether a similar trend exists in West Africa remains to be seen.

Vitamin B 12 and megaloblastic anaemia in South African Bantu. The major clinical features were weakness, joint pain and dark urine. Treatment is readily available for vitamin B 12 deficiency, so early recognition is important to ensure prompt replacement therapy.

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

Her symptoms cleared with vitamin B 12 treatment. At the time her Hb was 9. The present report concerns three cases of vitamin B 12 deficiency in Ghana.

It is visualized by drawing blood from a patient and viewing the blood smeared on a slide under a microscope.