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What are the criteria for reporting hypersegmented neutrophils in a male?

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what are the criteria for reporting hypersegmented neutrophils in a male adult patient having Hb of 14.7 gm%? Should anyone report such neutrophils in an asymptomatic person ?
Posted Mon, 6 May 2013 in X-ray, Lab tests and Scans
Answered by Dr. Luchuo Engelbert Bain 4 hours later
Hi and thanks for the query,
The better known causes of hypersegmentation of neutrophils are vitamin B12 or folate deficiency.Other causes include: iron deficiency , uremia, hyperthermia, myelodysplastic syndromes. Drugs including chemotherapy, steroids can induce neutrophil hypersegmentation. It is also known in a congenital condition (autosomal dominant) affecting 1% of the population. It is defined as any neutrophil with 6 or more lobes, or 5% of neutrophils with 5 lobes, or majority have more than 4 lobes. A lobe is considered distinct if it is separate from the nucleus or connected by a fine chromatin thread. It has been suggested that hypersegmentation can be most reliably detected by use of the segmentation index ( % of neutrophils with five lobes or more, relative to the number of four-lobed neutrophils).
20% of subjects with normal values can have occasional hypersegmented neutrophils.
However, it is very appropriate to screen for Vitamin B12 and Occult cobalamin levels, levels for the aforementioned rarer conditions. In case all of these are normal, then no need to worry.
Thanks and best regards,
Luchuo, MD.
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