Heinz Bodies

What are Heinz bodies?

Heinz bodies (Heinz-Ehrlich bodies) are tiny dots in red blood cells that medical pathologists can see when they examine cells under a microscope using a special dye. The red dots are particles of hemoglobin, a protein in your red blood cells. Heinz bodies are a sign of red blood cell damage and may be a sign of certain medical conditions like anemia.

How are Heinz bodies formed?

To understand how Heinz bodies develop, it may help to know more about red blood cell structure and function.

Most cells have three parts that help them function: a nucleus, cytoplasm and cell membrane. Mature red blood cells don’t have nuclei. Their empty interior makes room for trillions of hemoglobin molecules.

Hemoglobin is the protein that gives blood its characteristic red color. It’s also the reason why your red blood cells can carry oxygen throughout your body.

When something happens to hemoglobin, your red blood cells don’t work normally. They can’t carry oxygen throughout your body and they break down faster than usual (hemolysis).

What are hemolysis symptoms?

Symptoms depend on how low your red blood cell supply is. If your count isn’t too low, you may not notice symptoms. Symptoms often relate to having low oxygen because you have too few red blood cells to carry oxygen to your body’s cells and tissues.

Symptoms include:

• Fatigue.
• Dizziness.
• Pale skin.
• Heart palpitations (tachycardia).
• Shortness of breath (dyspnea).
• Yellowing of your skin and the whites of your eyes (jaundice).
• Enlarged spleen (splenomegaly).

What tests detect Heinz bodies?

Medical pathologists use peripheral blood smear tests (using a special dye) to detect Heinz bodies and other signs of damaged red blood cells. The special dye shows dark inclusion in cells with what is called oxidative damage to hemoglobin. This is denatured, or damaged, hemoglobin.

Pathologists may use the term “red blood cell inclusion” to describe Heinz bodies. (In medical terms, inclusions are temporary products of cell activity. Other examples of inclusion are Howell-Jolly bodies, Pappenheimer bodies and Hemoglobin H.)

What do Heinz bodies look like?

Viewed under a microscope, red blood cells with Heinz bodies may look like they have tiny blisters on the cell membrane. They may also look like something took a bite out of the cell. These are bite cells (degmacytes).

Bite cells happen as red blood cells travel through your spleen. Your spleen removes damaged or dying blood cells. Your spleen removes Heinz bodies from red blood cells, creating blood cells that look like someone took a bite out of them.

What conditions and diseases are associated with Heinz bodies?

Heinz bodies are associated with the following conditions and diseases:

• Heinz body anemia:Anemia happens when you don’t have enough healthy red blood cells. Heinz body anemia is anemia where tests detect Heinz bodies in red blood cells.
• Hemolytic anemia:This blood disorder happens when your red blood cells break down or die faster than normal.
• G6PD Deficiency: G6PD is glucose-6-phosphate dehydrogenase, an enzyme that protects your red blood cells from harmful substances. It’s an inherited (genetic) disorder. People with G6PD have an increased risk of hemolytic anemia. Babies with G6PD may develop jaundice.
• Alpha-thalassemia:Thalassemia affects your body’s ability to produce healthy red blood cells and hemoglobin.
• Enlarged spleen:Your spleen filters out damaged or dying red blood cells. Heinz bodies make your red blood cells break down or die faster than normal. When that happens, damaged or dying red blood cells may overwhelm your spleen, forcing it to expand.

Why do Heinz bodies occur?

Heinz bodies in red blood cells happen when something damages hemoglobin in your red blood cells. Causes may include:

• Exposure to certain drugs or chemicals, including some chemicals used in diagnostic tests.
• Certain medications, including medications to treat urinary tract infections and leprosy.
• Mineral deficiency, including selenium.
• People with G6PD deficiency may develop Heinz bodies after eating fava beans.

What are treatments for Heinz bodies?

There’s no specific treatment for Heinz bodies. They’re a symptom of an underlying issue like blood disorders, certain drugs or exposure to certain chemicals.

Can Heinz bodies be prevented?

Yes, they can. For example, people with G6PD can reduce their 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, so you aren’t exposed to treatment that increases your risk of developing Heinz bodies.

When should I call my healthcare provider?

Heinz bodies are a sign of underlying medical conditions that affect your red blood cells. If blood tests detect Heinz bodies, your healthcare provider will use that information to help diagnose your condition. Heinz bodies are signs of several conditions that affect red blood cells. Your provider is your best resource for information, including when you should contact them.

Why are these signs called Heinz bodies?

Heinz bodies are named after Dr. Robert Heinz. Heinz discovered them in 1890 while researching hemolytic anemia causes.

A note from Cleveland Clinic

Heinz bodies are changes in your red blood cells that may be signs of medical conditions or other issues. Specifically, Heinz bodies are tiny dots in red blood cells that medical pathologists can see when they use special dyes to examine cells under a microscope. The dots are particles of damaged hemoglobin, a protein in your red blood cells. Heinz bodies may be a sign of certain blood disorders, including inherited ones. If blood tests detect Heinz bodies, your healthcare provider will explain what the test results mean. They’ll also explain next steps, such as additional tests to confirm diagnosis and ways to treat the condition causing Heinz bodies.