Neutrophilic Hypersegmentation as an Indicator of Incipient Folic Acid Deficiency

Bills, Terence; Spatz, Lawrence

doi:10.1093/ajcp/68.2.263

Cited by 19 publications

(10 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…20 ' 21 The latter measurement sometimes produces abnormal results even when the lobe average is normal, [12][13][14][15][16][17][18][19][20] as we also found. Our results show that neutrophil hypersegmentation is not a common or reliable feature of mild cobalamin deficiency.…”

Section: Discussionsupporting

confidence: 63%

Neutrophil Nuclear Segmentation in Mild Cobalamin Deficiency:Relation to Metabolic Tests of Cobalamin Status and Observations on Ethnic Differences in Neutrophil Segmentation

et al. 1996

View full text Add to dashboard Cite

Neutrophil hypersegmentation is considered the most sensitive peripheral blood cell marker of cobalamin deficiency. However, its diagnostic value in the mild deficiency states that accompany most low cobalamin levels and its relation to metabolic tests of cobalamin status are unknown. The authors compared neutrophil lobe averages and percent neutrophils with 5 or more lobes (%5+ lobes) in 169 subjects with their mean corpuscular volume (MCV) and serum cobalamin, methylmalonic acid (MMA), homocysteine, and folate levels and, in 65 cases, with the deoxyuridine suppression test (dUST). Only 9 subjects had hypersegmentation by lobe average and 20 subjects by %5+ lobes. They were not more often cobalamin-deficient than subjects without hypersegmentation. Moreover, only one of 34 subjects with dUST results diagnostic for cobalamin deficiency had neutrophil hypersegmentation. Both indices of neutrophil segmentation in the 169 subjects correlated significantly with homocysteine levels. They also showed weak inverse correlation with cobalamin levels, but did not correlate with MMA, folate, Mild or subtle cobalamin deficiency is a relatively common phenomenon, probably far more frequent than the classical deficiency state with overt findings like megaloblastic anemia.' Anemia and macrocytosis are usually not evident and the blood count, being normal to start with, rarely changes significantly after treatment.2 "'' The bone marrow appearance is usually normal. This lack of or MCV values. Cobalamin therapy for 6 months did not significantly change neutrophil lobe averages in 35 subjects with mild deficiency, compared with 8 nondefkient controls, and only marginally improved the %5+ lobes. A surprising, incidental observation was that blacks had significantly greater neutrophil segmentation by both criteria than did whites and others. This difference was unrelated to cobalamin or folate status. Our results indicate that dUST abnormalities precede all morphologic changes of deficiency, including hypersegmentation. Although a tendency exists for neutrophil segmentation to increase very slightly as some serum values, especially homocysteine, start to worsen in mild cobalamin deficiency, the metabolic changes precede overt hypersegmentation. Neutrophil nuclear segmentation is insufficiently sensitive in relation to metabolic evidence of deficiency to be used as a clinical tool in the diagnosis of mild cobalamin deficiency.

show abstract

Section: Discussionsupporting

confidence: 63%

Neutrophil Nuclear Segmentation in Mild Cobalamin Deficiency:Relation to Metabolic Tests of Cobalamin Status and Observations on Ethnic Differences in Neutrophil Segmentation

et al. 1996

View full text Add to dashboard Cite

show abstract

“…She tabulated the number of lobes in 100 PMNs in each of two different areas of high-quality blood smears prepared with Wright's stain. The average poly lobe count in 25 normal volunteer house officers and medical students was 3.24 k 0.10 SD, a value similar to that reported by others [2,3]. To assess the reproducibility of the poly lobe counts, each of three blood smears was examined "blinded" at random at least ten times, mingled in with the patients' blood smears.…”

Section: Methodssupporting

confidence: 79%

Steroid‐induced hypersegmentation in neutrophiles

Eichacker

Lawrence

1985

American J Hematol

View full text Add to dashboard Cite

The effect of glucocorticoid administration on the nuclear segmentation of circulating granulocytes was studied in 13 patients with hematologic disorders and in two normal volunteers. In seventeen of eighteen courses, the granulocyte nuclear lobe count increased from 3.24 +/- 0.12 (SD) to 3.41 +/- 0.12 by the third day of treatment (P less than .001). Nuclear segmentation increased even further with continued therapy during a week of observation. Thus, like deficiencies of folate and of vitamin B12, glucocorticoid therapy causes neutrophil hypersegmentation. The cause of this effect is not known.

show abstract

“…Hypersegmentation is rare, was described first in persons with folate or vitamin B12 deficiency, and more recently as a hallmark of two distinct PMN subsets (5, 8, 26, 27). As a fivefold excess of folate and/or vitamin B12 had no effect on nuclear morphology in our system (Supplemental Fig.…”

Section: Resultsmentioning

confidence: 99%

Cutting Edge: Helicobacter pylori Induces Nuclear Hypersegmentation and Subtype Differentiation of Human Neutrophils In Vitro

Whitmore

Weems

Allen

2017

The Journal of Immunology

View full text Add to dashboard Cite

Helicobacter pylori infects the human stomach and causes a spectrum of disease that includes gastritis, peptic ulcers, and gastric adenocarcinoma. A chronic, neutrophil-rich inflammatory response characterizes this infection. It is established that H. pylori stimulates neutrophil chemotaxis and a robust respiratory burst, but other aspects of this interaction are incompletely defined. We demonstrate here that H. pylori induces N1-like subtype differentiation of human neutrophils as indicated by profound nuclear hypersegmentation, a CD62Ldim, CD16bright, CD11bbright, CD66bbright, CD63bright surface phenotype, proinflammatory cytokine secretion, and cytotoxicity. Hypersegmentation requires direct neutrophil-H. pylori contact as well as transcription and both host and bacterial protein synthesis, but not urease, NapA, VacA, CagA or CagT. The concept of neutrophil plasticity is new, and to our knowledge these data are the first evidence that neutrophils can undergo subtype differentiation in vitro in response to bacterial pathogen infection. We hypothesize that these changes favor H. pylori persistence and disease.

show abstract

Neutrophilic Hypersegmentation as an Indicator of Incipient Folic Acid Deficiency

Cited by 19 publications

References 0 publications

Neutrophil Nuclear Segmentation in Mild Cobalamin Deficiency:Relation to Metabolic Tests of Cobalamin Status and Observations on Ethnic Differences in Neutrophil Segmentation

Neutrophil Nuclear Segmentation in Mild Cobalamin Deficiency:Relation to Metabolic Tests of Cobalamin Status and Observations on Ethnic Differences in Neutrophil Segmentation

Steroid‐induced hypersegmentation in neutrophiles

Cutting Edge: Helicobacter pylori Induces Nuclear Hypersegmentation and Subtype Differentiation of Human Neutrophils In Vitro

Contact Info

Product

Resources

About