Heinz body



Heinz bodies (also referred to as "Heinz-Ehrlich bodies") are inclusions within red blood cells composed of denatured hemoglobin.

They are named after Robert Heinz (1865-1924), a German physician who in 1890 described these inclusions in connection with cases of hemolytic anemia.

Form and appearance
Heinz bodies appear as small round inclusions within the red cell body, though when stained with Romanowsky dyes they may appear as projections from the cell. They appear clearly when supravitally stained (e.g., with methylene blue or bromocresyl green).

Etiology and associated disorders
Heinz bodies are formed by damage to the hemoglobin component molecules, usually through oxidations, which causes the damaged molecules to precipitate and damage the cell membrane. Damaged cells are attacked by macrophages in the spleen, where the precipitate and damaged membrane is removed, leading to characteristic "bite cells". The denaturing process is irreversible and the continual elimination of damaged cells leads to Heinz body anemia.

There are several pathways leading to the hemoglobin damage. In α-thalassemia the Hemoglobin H molecules, being composed of four beta chains, are unstable and become damaged with time. G6PD (Glucose-6-Phosphate Dehydrogenase) deficiency brought on by administration of oxidant drugs (e.g., primaquine) also can result in Heinz bodies.

In veterinary medicine Heinz bodies are especially associated with the consumptions of onions by cats, dogs, and various primates, and a symptom of paracetamol poisoning in cats. Thiosulfate compounds in the flesh of onions have been identified as the cause.

Treatment
There is no specific treatment for Heinz bodies; however they are important as a diagnostic indicator for the causative conditions listed above.

Additional Resources

 * Heinz bodies in Dorland's Medical Dictionary
 * "Unstable Hemoglobins: The Role of Heme Loss in Heinz Body Formation" Jacon, Harry and Winterhalter, Kaspar, Proceedings of the National Academy of Sciences, Vol. 64, No3, pp. 697-701, March 1970
 * "Heinz Body Anemia in Cats" Tarigo-Martinie, Jaime and Krimer, Paula (accessed Sept. 2006)
 * Anemia caused by onions Wissman, Margaret A., Simian, date unknown