HOME HELP FEEDBACK SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Services Similar articles in this journal Alert me to new content in the Image Bank Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Lazarchick, J. Search for Related Content PubMed Articles by Lazarchick, J. Related Collections Hemolytic Disorders Related ASH-SAP Chapter Related Image Bank Image Sets Related ASH Education Book Articles Social Bookmarking                   What's this?

Hemoglobin S/HPFH

View larger version (154K): [in this window] [in a new window]   Figure 1. Peripheral smear from a 23 year old African-American female is shown. She was seen in the Prenatal Wellness Diagnostic Center for genetic counseling. Her CBC included a hemoglobin of 11.9g/dL, WBC of 7360/uL with a normal differential and platelet count of 244k/uL. Her MCV was 69 fl and a RDW of 12.3%. Her sickle cell screen was positive and her hemoglobin electrophoresis revealed 48.2% S, 48.1% F and 3.7% A2. Her RBCs are 1+ microcytic and normochromic. Only an occasional polychromatophilic RBC. In addition a rare target cell is noted.

View larger version (188K): [in this window] [in a new window]   Figure 2. A Kleihauer-Betke stain on a 9 part: 1 part mixture of normal adult RBCs and fetal RBCs is shown. The darkly pink staining RBCs are the fetal RBCs which contain >80% hemoglobin F.

View larger version (178K): [in this window] [in a new window]   Figure 3. The difference between the staining of fetal and normal adult RBCs is better illustrated at the higher magnification shown. The fetal RBCs are intensely pink while the adult normal RBCs have a washed out ghost-like appearance.

View larger version (189K): [in this window] [in a new window]   Figure 4. A low power view of the patient's Kleihauer-Betke stain is shown. Even at this magnification there appears to be a homogeneous stain throughout the RBC population.

View larger version (182K): [in this window] [in a new window]   Figure 5. The homogeneity of staining in the patient's RBCs is illustrated more clearly in this view. Essentially all of her RBCs have pink staining although it appears to be more intense in some of her cells as opposed to others. Note that the intensity if staining is intermediate to that noted in the fetal cells shown in figure 2.

View larger version (182K): [in this window] [in a new window]   Figure 6. This variability in intensity of staining within each RBC can be seen. All cells are positive for the presence of fetal hemoglobin but the amount of it in any one cell would appear to vary.

CiteULike

Connotea

Del.icio.us

Digg

Reddit

Technorati

Related Image Bank Image Sets

Sickle Cell Anemia

Stanley Schrier
ASH Image Bank 2001 2001: 100248. [Full Text]

Acanthocyte

Peter Maslak
ASH Image Bank 2005 2005: 101352. [Full Text]

Homozygous Hemoglobin C Disease

John Lazarchick
ASH Image Bank 2005 2005: 101384. [Full Text]

Hemoglobin S/C Disease

Peter Maslak
ASH Image Bank 2005 2005: 101406. [Full Text]

Triconcave Erythrocytes

Jon Fukumoto and Jason Gotlib
ASH Image Bank 2006 2006: 600018. [Full Text]

Sickle cell anemia

Peter Maslak
ASH Image Bank 2008 2008: 800074. [Full Text]

Related ASH Education Book Articles

Hemoglobinopathies

George F. Atweh, Joseph DeSimone, Yogen Saunthararajah, Hassana Fathallah, Rona S. Weinberg, Ronald L. Nagel, Mary E. Fabry, and Robert J. Adams
Hematology 2003 2003: 14-39. [Abstract] [Full Text]

An Evidence-Based Approach to the Treatment of Adults with Sickle Cell Disease

Richard Lottenberg and Kathryn L. Hassell
Hematology 2005 2005: 58-65. [Abstract] [Full Text]

Induction of Fetal Hemoglobin in the Treatment of Sickle Cell Disease

Hassana Fathallah and George F. Atweh
Hematology 2006 2006: 58-62. [Abstract] [Full Text]

Related ASH-SAP Chapter:

This Article Figures Only Services Similar articles in this journal Alert me to new content in the Image Bank Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Lazarchick, J. Search for Related Content PubMed Articles by Lazarchick, J. Related Collections Hemolytic Disorders Related ASH-SAP Chapter Related Image Bank Image Sets Related ASH Education Book Articles Social Bookmarking                   What's this?