Blood/Blood Cells and Cellular Components ›› Red Blood Cells ›› Abnormal

Hemoglobin H Inclusion*


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› Microscopic Features:

• Multiple small blue-purple granules distributed within an RBC and visualized with special stain
• Composed of precipitated chains of beta-hemoglobin (tetramer of beta chain) seen in some alpha thalassemia

› Normal % blood-PB, marrow-BM, lymphoid tissue-LN:

• PB: None
• BM: None
• LN: None

› May Resemble:

• Heinz bodies (visible only after supravital stain) [Compare]
• Pappenheimer bodies [Compare]
• Howell-Jolly body [Compare]
• Basophilic stippling [Compare]
• Malaria infection [Compare]
• Babesia infection [Compare]
• Artifacts (e.g. Stain precipitate)

› Differential Diagnoses:

Alpha Thalassemia Myeloproliferative syndromes (sometimes) Erythroleukemia (AML-M6): sometimes

› Classic Immunophenotype:

• N/A

› Cartoon Image:


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› Misc:

• Seen with special supravital stain. In some alpha thalassemias, the decreased production of alpha chains leads to an excess of beta chains which can form beta-tetramers and precipitate