The Relationship between Iron Deficiency Anemia and Neutrophil Hypersegmentation

Um, Tae Hyun; Cho, Chong Rae

Abstract

BACKGROUND: Neutrophil hypersegmentation (NH) in peripheral blood is known to be usually associated with deficiency of vitamin B12 or folate. Iron deficiency anemia (IDA) is another suggested cause of NH based on a limited number of studies, but the mechanism is uncertain. There was no such study in Korea.
METHODS
The study groups were 41 patients with IDA (four males, 37 females ; mean age, 43.63+/-15.71) and 39 hematologically normal patients (five males, 34 females ; mean age, 46.64+/-19.12). We counted the number of nuclear lobes for 100 neutrophils on Wright-stained peripheral blood smear. Two lobes were regarded as separate only if there was a clear filament or the isthmus between them contained no nuclear material. The neutrophils with uncertainty in nuclear lobe count were classified as 'folded'.
RESULTS
NH was observed in 14.6% (6/41) of patients with IDA and 7.6% (3/39) of normal controls. Mean neutrophil lobe counts were 2.48+/-0.28 and 2.43+/-0.27, respectively. There was no statistical significance in these differences.
CONCLUSION
We could not find significant relation between NH and IDA in Korean, which is different from studies performed in other countries. This result may suggest the possibility of racial differences in the mechanism connecting IDA and NH, if there is any.