Blood/Blood Cells and Cellular Components ›› Red Blood Cells ›› Abnormal
Hemoglobin H Inclusion
›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
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