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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Work performed in North Africa 4 and Zimbabwe 5 did show a higher female to male ratio in the incidence of the disease.
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 hypereegmented for diagnosis in West Africa. A positive Schillings test for malabsorption for all of them would have further supported a diagnosis of pernicious anaemia but could not be performed.
The greater number of cases may not have a typical presentation. Recent reports show that serum vitamin B 12 value alone is insufficient for the diagnosis of vitamin B 12 deficiency.
Conditions Associated with Hypersegmented Neutrophils – , Laboratory Continuing Education
Modern approaches to the investigation of vitamin B 12 deficiency. Author information Copyright and License information Disclaimer. In case 1, the patient was initially managed as suspected haemolytic anaemia and depression with folic acid and tryptizol.
Hypersegmented neutrophils and oval macrocytes in the setting of B12 deficiency and pancytopaenia.
She had experienced hypertension of duration 3 years that was well controlled on nifedipine. National Center for Biotechnology InformationU. Her symptoms cleared with vitamin B 12 treatment. 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  .
It is interesting that all the cases in the present report were women. Abnormal clinical and laboratory findings for blood tests R70—R79 Surgical pathology Cytopathology Autopsy Molecular pathology Forensic pathology Oral and maxillofacial pathology Gross examination Yhpersegmented Immunohistochemistry Electron microscopy Immunofluorescence Fluorescence hypersegemnted situ hybridization. This is a clinical laboratory finding. In spite of the high serum vitamin B 12 value, the patient was anaemic, showed hypersegmented neutrophils, weakness and hyperpigmentation.
Galloway M, Macrocytosis Hamilton M: Both responded well to treatment with vitamin B 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. Vitamin B 12 and megaloblastic anaemia in South African Bantu. Diagnosis of cobalamin deficiency I: She was on a normal mixed diet and neither drank alcohol nor smoked.
Desk Reference for Hematology, Second Hy;ersegmented. Am J Hematol ; These pointed to vitamin B 12 deficiency rather than Addison disease, which was thus not pursued.
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Vitamin B 12 deficiency. Ivy Adwowa Efiefi Ekem. Hypoglycemia Hyperglycemia Prediabetes Impaired fasting glucose Impaired glucose tolerance Oxyhyperglycemia.
Articles which use infobox templates with no data rows. Vitamin B 12 cobalamin and folate deficiency constitute the commonest causes of megaloblastic anaemia.
One case presented in the expected textbook manner with neurological signs, anaemia and a low serum vitamin B 12 level, whereas another presented with anaemia and hyperpigmentation, but a high serum vitamin B 12 level.
Diagnosis of megaloblastic anaemias. Megaloblastic anemia and other causes of macrocytosis. In other projects Wikimedia Commons. She readily responded to treatment accompanied by a reversal of the hyperpigmentation, loss of her numbness, weakness and blackouts, a rise in Hb and normalisation of neutrophil segmentation. From Wikipedia, the free encyclopedia.
Blood Rev ; It is not clear to us what might have accounted for the high serum vitamin B 12 value, but high intrinsic factor antibodies have been reported to be a cause of such a finding.