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Heinz Body Preparation

The Heinz body preparation is performed in the work up for unstable hemoglobins. Heinz bodies (also referred to as Heinz-Erlich bodies) are inclusions within red blood cells composed of denatured hemoglobin. Heinz bodies are formed by damage to hemoglobin molecules as a result of oxidative stress or an inherited mutation that leads to a change in an internal amino acid residue. The denaturing process is irreversible and continued elimination of damaged cells leads to a hemolytic anemia, or Heinz body anemia. Certain medications, pickled foods that are high in nitrates, and mothballs can cause the formation of Heinz bodies. Inherited genetic mutations such as G6PD, and thalassemia also cause the formation of Heinz bodies and hemolytic anemia. Damaged red cells are cleared by macrophages in the spleen, where the precipitated hemoglobin and damaged membrane are removed, leading to characteristic “bite cells” on the peripheral smear. Heinz bodies appear as small round inclusions within the red cell when supravitally stained with new methylene blue or bromocresyl green. They are more likely to be present after splenectomy.

 

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