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Case report
Acquired Pelger-Huët anomaly in a patient treated with valganciclovir
  1. Elva Nieto-Borrajo and
  2. Alfredo Bermejo-Rodriguez
  1. Clinical Laboratory, Hospital Universitario de Fuenlabrada, Fuenlabrada, Spain
  1. Correspondence to Dr Elva Nieto-Borrajo; melva.nieto{at}


A follow-up blood count was performed on a 74-year-old woman diagnosed with colitis due to cytomegalovirus and under treatment with valganciclovir. The automated complete blood count revealed an abnormal white blood cells (WBC) scattergram together with WBC alert flags. The peripheral blood smear showed neutrophils with markedly hyposegmented nuclei or bilobed nuclei and very condensed chromatin or clumping chromatin all consistent with Pelger-Huët anomaly (PHA). We checked previous blood counts, ruling out an inherited PHA. We assessed the haematological, infectious and iatrogenic aetiologies for an acquired PHA. Once the valganciclovir treatment was completed and the drug was withdrawn, without changing the rest of the treatment, the morphological abnormalities of neutrophils were completely resolved. We conclude therefore that the acquired PHA presented by our patient is probably related to valganciclovir treatment.

  • drugs: infectious diseases
  • haematology (including blood transfusion)
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  • Contributors EN-B: planning, conduct and reporting of the work. AB-R: revising and editing the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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