HematologyOutlines - Atlas
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)
  • Pappenheimer bodies
  • Howell-Jolly body
  • Basophilic stippling
  • Malaria infection
  • Babesia infection
  • 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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RBC
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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