Steroid‐induced hypersegmentation in neutrophiles

Abstract

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.

Cytoskeletal influences on nuclear shape in granulocytic HL-60 cells

“…The present data with RA treated HL-60- bcl -2 cells suggests that delayed or dysfunctional apoptosis might play a role in these human diseases. It is of interest that neutrophil nuclear multilobulation (hypersegmentation) has been described in two circumstances that delay apoptosis: 1) Glucocorticoid administration to patients induces hypersegmentation [36], and in vitro glucocorticoid treatment of neutrophils prolongs their survival [37-39]. 2) Granulocyte colony-stimulating factor (G-CSF) administration to rats induces hypersegmentation in mature neutrophils [40], and in vitro treatment of neutrophils with G-CSF prolongs their survival [38,41].…”

A woman with macrocytic anaemia and confusion

“…It can also occur in patients receiving chemotherapeutic agents such as hydroxyurea and 5-fluorouracil or steroids. 7 The mechanism behind hypersegmentation is unclear. Our patient also had raised lactate dehydrogenase and bilirubin, along with a low haptoglobin.…”