a. What does the blood film show?

b. What could be responsible for this appearance?

c. What is the most likely diagnosis in this case?

Click here for the answers

This is the blood film of a patient with lethargy and poor vision.

a. What does the blood film show?

The neutrophil shows hypersegmentation of nucleus.

b. What could be responsible for this appearance?

Folate or Vitamin B12 deficiency.
Both are needed for the normal development of haemopoietic 
tissue. The deficiency of either causes megaloblastic anaemia. 
The hypersegmentation of the nucleus is caused by defective 
DNA synthesis. 

c. What is the most likely diagnosis in this case?

Vitamin B12 deficiency.
Vitamin B12 deficiency causes neurological symptoms in addition 
to megaloblastic anaemia. The neurological symptoms include 
subacute combined degeneration of the cord and optic atrophy.

Click here to return to the main page