Hypersegmented neutrophils on a peripheral smear are most closely associated with a deficiency in which nutrient?

Hypersegmented neutrophils on a peripheral smear are most closely associated with a deficiency in which nutrient?

• A. Vitamin B12
• B. Vitamin C
• C. Vitamin E
• D. Vitamin A

Answer: (A)

Hypersegmented neutrophils signal a megaloblastic process from impaired DNA synthesis in hematopoietic cells. Vitamin B12 deficiency best explains this finding among the options because B12 is a crucial cofactor for DNA synthesis; when it’s deficient, nuclear maturation lags behind cytoplasmic development, leading to megaloblasts and neutrophils with hypersegmented nuclei. This is classically seen in megaloblastic anemia due to B12 deficiency (e.g., pernicious anemia or malabsorption). Folate deficiency can cause the same morphological changes, but that option isn’t provided here. Deficiencies of vitamins C, E, or A produce different clinical pictures (scurvy, neurologic/hemolytic issues, and vision/epithelial problems, respectively) rather than hypersegmented neutrophils.

Hypersegmented neutrophils signal a megaloblastic process from impaired DNA synthesis in hematopoietic cells. Vitamin B12 deficiency best explains this finding among the options because B12 is a crucial cofactor for DNA synthesis; when it’s deficient, nuclear maturation lags behind cytoplasmic development, leading to megaloblasts and neutrophils with hypersegmented nuclei. This is classically seen in megaloblastic anemia due to B12 deficiency (e.g., pernicious anemia or malabsorption). Folate deficiency can cause the same morphological changes, but that option isn’t provided here. Deficiencies of vitamins C, E, or A produce different clinical pictures (scurvy, neurologic/hemolytic issues, and vision/epithelial problems, respectively) rather than hypersegmented neutrophils.