European Journal of Molecular & Clinical Medicine

Background: Hypersegmentation of neutrophils is defined as presence of 5% or more neutrophils with five or more lobes or single neutrophil with 6 lobes. It is usually associated with deficiency of or failure to utilize cobalamin or folate and impaired DNA synthesis. Aims & Objectives: to find out any abnormality in the neutrophils of those subjects having hypersegmented neutrophils, to assess the manifestations in peripheral smear of these patients and to find out any association of the presence of hyper segmented neutrophils in peripheral smear with Vitamin B12 level, folic acid level and platelet count. Methodology: A prospective study was carried out from November 2021 to June 2022 in the department of pathology of a tertiary care teaching hospital of Government medical college, Betiah, Bihar among 136 study participants by total consecutive sampling. Patients having hypersegmented neutrophils were administered for data collection and were subjected to further tests. Analysis of data was done using SPSS software version 22. Multivariate regression analysis was performed and the value of p< 0.5 was taken as statistically significant. Results:  Hypersegmented neutrophils were present more commonly in females (75 out of 136, 55%) as compared to those of males (61 out of 136, 45%). Most of the study participants 81 out of 136 (59.56%) were in the age group of 31-60 years and educated upto primary level (52 out of 136, 38.24%). The various abnormalities in neutrophils in addition to hypersegmentation seen were cytoplasmic toxic granules, cytoplasmic vacuoles and dohle bodies. The peripheral smear has macrocytic normochromic appearance in about 35.29% of the cases.  Lower vitamin B12 levels was significantly associated (p < 0.01) with presence of hypersegmented neutrophils.
Conclusion: The presence of hypersegmented neutrophils were significantly associated with lower vitamin B12 levels which is one of its possible causative factor.