Heinz Bodies

What are Heinz bodies?

Heinz bodies (Heinz-Ehrlich bodies) are clumps of damaged hemoglobin, a protein in your red blood cells. Pathologists can see them when they view red blood cells under a microscope using a special dye. Heinz bodies are a sign of red blood cell damage that may indicate several conditions.

To understand Heinz bodies, it may help to know more about red blood cells and hemoglobin. Hemoglobin helps your red blood cells carry oxygen throughout your body. But problems with hemoglobin can cause red blood cells to break down. This can leave you with low red blood cells, or hemolytic anemia.

In 1809, Dr. Robert Heinz discovered these pieces of damaged, or “denatured,” hemoglobin in red blood cells. At the time, he was researching causes of hemolytic anemia. That’s where “Heinz bodies” get their name.

What do Heinz bodies look like?

Pathologists use peripheral blood smear tests (using a special dye) to see Heinz bodies and other signs of damaged red blood cells. Viewed under a microscope, Heinz bodies may look like they have tiny blisters on the outer surface (membrane) of red blood cells.

Eventually, all blood cells make their way to your spleen. Your spleen removes damaged or dying blood cells. It also removes Heinz bodies from red blood cells. This creates blood cells that look like something took a bite out of them. These cells with Heinz bodies removed are called bite cells (degmacytes).

What is Heinz body hemolytic anemia?

Heinz bodies don’t always mean your red blood cell count is low. But when it does, your provider may call your condition Heinz body hemolytic anemia. Depending on how low your levels are, you may experience symptoms like:

• Dizziness
• Enlarged spleen
• Fatigue
• Heart palpitations
• Pale skin
• Shortness of breath
• Yellowing of your skin and the whites of your eyes

Your symptoms and the presence of Heinz bodies can help your healthcare provider find out what’s causing issues.

What are the most common causes of Heinz bodies?

Heinz bodies in red blood cells happen when something damages hemoglobin in your red blood cells. This damage is also called oxidative stress. Causes include:

• G6PD Deficiency, an inherited genetic disorder that increases your risk of hemolytic anemia
• Alpha thalassemia, an inherited blood disorder that affects your body’s ability to produce hemoglobin
• Exposure to chemicals, including some used in dyes, mothballs and medical tests
• Some medications, including drugs that treat urinary tract infections and leprosy
• Selenium (a type of mineral) deficiency

How are Heinz bodies treated?

There’s no specific treatment for Heinz bodies. Instead, you may need treatment for the condition that’s causing them. Depending on the cause, your healthcare provider may recommend:

• Blood transfusion
• Spleen removal
• Stem cell transplant
• Stopping or changing any medications causing issues, if possible
• Taking a selenium supplement to treat a deficiency

Make sure to talk to your provider before stopping or changing your medicines. They can help you do so safely.

Can Heinz bodies be prevented?

Some causes of Heinz bodies are preventable. For example, if you have G6PD deficiency, you can reduce your risk of developing Heinz bodies by not eating fava beans. If you have a urinary tract infection, you may want to ask about the drugs used to treat it. Your healthcare provider can let you know if they put you at risk of anemia.

You can’t prevent conditions you’re born with that cause Heinz bodies. But you can work with your healthcare provider to manage them.

When should Heinz bodies be treated by a doctor or healthcare provider?

Heinz bodies are a sign of several conditions that affect your red blood cells. Their presence in your red blood cells tells your provider to investigate further. If a blood test reveals Heinz bodies, your provider will use that information to help diagnose your condition. They’ll explain your treatment options based on their findings.

What is the difference between Heinz bodies and Howell-Jolly bodies?

Both are “red blood cell inclusions” that can appear in lab test results. But they provide different information. An inclusion is material that doesn’t belong in the cell.

With Heinz bodies, the material is damaged hemoglobin. Howell-Jolly body inclusions are leftover pieces of cell DNA. It’s a sign that an immature red blood cell didn’t shed its nucleus (as it should) during development. It may mean your spleen isn’t getting rid of damaged blood cells.

Your healthcare provider can explain what having Heinz bodies or Howell-Jolly bodies means for your health.