Acquired Pelger-Huët Anomaly Limited to Eosinophils

Acquired Pelger-Huët Anomaly Limited to Eosinophils V. Fossaluzza F. Tosato IV Divisione Medica, Ospedale Civile S. Maria della Misericordia, I-33100 Udine (Italy) Sir, We wish to report a new case of acquired Pelger-Huët anomaly confined to eosinophils. This unusual alteration was observed in a 68-year-old woman with typical agnogenic myeloid metaplasia. The laboratory data revealed moderate normocytic normochromic anemia, thrombocytopenia and leukocytosis (11T09/1). Bone marrow sections demonstrated moderately severe myelofibrosis. The leukocyte alkaline phosphatase score and the chromosomes were normal. Peripheral blood smears showed erythrocytes with striking tear-drop poikilocytosis, a leu-koerythroblastic reaction and many giant platelets and megakaryocytic fragments. Eosinophilic cells were 2%, all of them presented round pyknotic nuclei with clumped chromatin (fig. 1) while neutrophils had a normal nuclear segmentation. This phenomenon was never noted during previous admissions. Moreover the patient had never been treated with myelotoxic agents. Acquired or pseudo Pelger-Huët anomaly limited to eosinophils, first described by Kay et al. [2] in 2 cases of myeloprolifer-ative syndrome, was recently reported by us [1] in a patient with acute myeloblastic leukemia. Because of this further observation we believe that the anomaly is not so rare as previously appreciated, and it is probably an intrinsic part of various conditions of disordered myelopoiesis. Sincerely yours, V. Fossaluzza and F. Tosato