Erythrocyte Disorders: Smear Case 3: Intracellular RBC Inclusions

Heinz body formation

  • Heinz bodies are 1-3 um particles of denatured hemoglobin settling eccentrically, usually close to the red cell membrane.
  • They are found in erythrocytes in unstable hemoglobin disorders, acute drug induced hemolysis, and following splenectomy.
  • Their formation may be exaggerated by in-vitro incubation of a fresh blood sample with phenylhydrazine.
  • Heinz bodies, as pictured here, are identified using a supra-vital stain, such as new methylene blue or cresyl violet.
  • Bite cells, visible with Wright-Giemsa staining, are visual reminders that the spleen is functional and has pitted the aberrant chunk of hemoglobin from the circulating erythrocyte.

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