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Pappenheimer Bodies in Sickle Cell Disease

View larger version (73K): [in this window] [in a new window]   Figure 1. A 26-year-old AF male with sickle cell disease who presented to the ER complaining of abdominal pain. His CBC at that time showed a hemoglobin of 7.2g/dL, WBC of 11.2k/uL and a platelet count of 360k/uL. His peripheral smear is show. Sickle cells are readily identified (intermediate-sized arrow) throughout the smear. A RBC with a Howell-Jolly body (small arrow) is also noted. Multiple irregular inclusions (large arrow) are present in many of the other RBC. These iron-containing granules are Pappenheimer bodies. A Prussian Blue is needed to confirm the presence of non-heme iron in these granules. Also note on this smear increased polychromatophilic cells and target cells.

View larger version (129K): [in this window] [in a new window]   Figure 2. At a higher magnification, many of the RBCs can be seen to contain single or multiple irregular granules (small arrow). The larger arrow shows a typical sickle cell.

View larger version (126K): [in this window] [in a new window]   Figure 3. This image best illustrates the difference between Pappenheimer bodies and Howell-Jolly bodies. The large arrow depicts a RBC with a Howell-Jolly body. Note: this is a single round dense structure with a regular border, as opposed to the Pappenheimer bodies (small arrow), which are frequently multiple inclusions with irregular borders. Howell-Jolly bodies are fragments of DNA and typically seen in the peripheral smears of individuals with sickle cell disease following auto-splenectomy. A nucleated RBS is also present in this view.

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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 Iron and Blood Loss Related ASH-SAP Chapter Related Image Bank Image Sets Related ASH Education Book Articles Social Bookmarking                   What's this?