Dogs that survive may have leukocytes with round to oval nuclei on a stained blood smear. Conversely, the homozygous anomaly is usually lethal in utero. Heterozygous anomaly is not associated with immunodeficiency, with predisposition to infection, or with abnormalities of leukocyte (white blood cell) function. The heterozygous version is more common and is recognized because the dog's mature neutrophils resemble bands (slightly immature neutrophils) and metamyelocytes (a predecessor of granular leukocytes). There are two types of this benign defect: heterozygous and homozygous. For the most part, this is a harmless disorder which affects several breeds of dogs, including the American foxhound, Australian shepherd, and basenji. This morphology on peripheral smear examination in association with pancytopenia with no history of medication and infection was highly suggestive of Myelodysplastic syndrome.Pelger-Huët anomaly is an inherited disorder characterized by the hyposegmentation of neutrophils (a type of white blood cell), whereby the nucleus of the cells has only two lobes or no lobes at all. Peripheral smear examination revealed 7-8% of the neutrophils having bi-lobed nuclei with condensed chromatin and hypogranulation of cytoplasm. In Our case, 72 years old male patient presented with pancytopenia (Haemoglobin : 10.8 g/dl, leukocyte count : 3 × 10^9/L with and platelet counts : 29 × 10^9/L). Identification of drug-related cases requires knowledge of the clinical history and a high index of suspicion.
Toxic changes of granulocytes may also be seen in cases associated with infection. In both reactive conditions and dysplastic-type changes, only a subset of neutrophils is usually affected, in contrast to the entire population in Pelger-Huet anomaly. In particular, isolated isochromosome 17q is a cytogenetic abnormality specifically associated with these changes. In the case of myelodysplastic syndrome (MDS) or other myeloid neoplasms, the hypolobation is often accompanied by hypogranulation of neutrophils, as well as other dysplastic changes seen in erythroid elements, platelets, and megakaryocytes. Myelodysplastic syndromes or other myeloid stem cell disorders.ĭistinguishing true Pelger-Huet anomaly from mimics, though straightforward, is usually important as it may lead to unnecessary investigations like bone marrow examination.Medications or drugs such as mycophenolate or valproate,.Reactive conditions associated with severe infections,.Morphologic mimics of Pelger-Huet anomaly ( Psuedo-Pelger-Huet Anomaly) are more common than the true disorder.The changes of hypolobation can be seen primarily in three circumstances associated with. Pseudo-Pelger-Huet Anomaly or Pelgeroid change ( PPHA) is characterized by hyposegmentation of the neutrophil nucleus and chromatin clumping. Author: DR PREETAMKUMAR JAIN, DR RUPALI PARIKHĬategory: Laboratory Hematology > Basic cell morphology > Morphologic variants of white blood cells > Hyposegmented neutrophil
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