Rbc inclusion ()))))

pappenheimer body howell-jolly bodies heinz bodies cabot ring and bassophilic stipling

1. Presented by Group 6 Presented to Miss Mehreen Red blood cell inclusion

2. Introduction Inclusion bodies are those things that just appear in cells and.. don’t really  do  anything. They’re just included within the cell, for some purpose Typically, inclusion bodies are nuclear or cytoplasmic aggregates of stainable substance, usually proteins In RBC it is indication of some pathological conditions

3. Introduction These bodies are never enclosed by a membrane and serve as storage vessels . Glycogen, which is a polymer of glucose, is stored as a reserve of carbohydrate and energy. it is useful to understand each inclusion body that can occur within a red blood cell.

4. Contt… Following are the inclusion bodies with in RBC Howell-Jolly Body Heinz Body Pappenhemier Body Basophilic Stippling Cabot Ring

5. Pappenheimer Body Pappenheimer bodies are abnormal inclusions of iron found inside RBC on a routine blood stain Formed by phagosomes that have engulfed excessive amounts of iron Pappenheimer bodies are basophilic erythrocytic inclusions usually Located at the periphery of the cell They appear as dense, blue-purple granules within the red blood cell 1 or 2 in number

6. Causes Pappenheimer bodies are most likely caused by accelerated red cell division or impaired hemoglobin synthesis

7. Lab diagnosis Can be visible with Wright or Giemsa stain Prussian blue is more useful for identification and differentiation Cells containing Pappenheimer bodies can be confused with late reticulocytes but it can not take prussian blue stain They also stain with Romanowsky stains because of co-precipitation of ribosomes Blood cell morphology Reticulocyte count MCV Blood film

8. Diseases Associated Splenectomy Hemolytic Anemia Sideroblastic Anemia Megaloblastic Anemia Hemoglobinopathies The exact cause of Pappenheimer bodies in these diseases is unknown.

9. HOWELL-JOLLY BODIES DEFINITION:Histopathologic findings of basophilic nuclear remenants in circulating erythrocytes TERMINOLOGY:Micronucleated Reticulocytes SIZE:1 micronmeter in diameter APPEARANCE:Small rounded,dense purple granules

10. Cont… COMPOSITION: Deoxyribonucleic acid (DNA) Nuclear remenants SITES: Circulating erythrocytes Erythroid precursors in bonemarrow ASSOCIATED WITH:Rapid or abnormal RBCs formation

11. Contt… PATHOPHYSIOLOGY: During Maturation in bonemarrow .Erythrocytes normally expels nuclei But sometimes small portion of DNA remains

12. contt… CONDITIONS: Autospleenectomy due to sickle cell anemia Hereditary spherocytosis Megaloblastic anemia Myelodysplastic syndrome . Severe haemolytic anemia Spleenectomy DIAGNOSIS: Peripheral blood smear Wright stain (methylene blue + eosine) Remenants of nucleus (DNA) observes

13. Heinz Body Heinz bodies are inclusions within red blood cells composed of denatured  hemoglobin. Heinz bodies appear as small round inclusions within the red cell body.

14. Contt… Heinz bodies are formed by damage and denaturing to the hemoglobin component of red blood cells, most commonly by oxidative stress, but also possibly by genetic abnormalities in hemoglobin. Typically, during oxidative damage to hemoglobin, an electron is transferred from the hemoglobin to oxygen, resulting in the formation of a  reactive oxygen species (ROS).  This ROS can lead to severe damage within the cells, and can even cause lysis of the entire cell.

15. Contt… The ROS denatures portions of the hemoglobin, causing the to precipitate and produce Heinz Bodies, which becomes an antigenic agent. Thus, macrophages detect the antigen and remove the damaged portions of the cell, its damaged membrane and the denatured hemoglobin (now called the Heinz Body).

16. Causes G6PD deficiency  NADPH Deficiency Chronic Liver Disease Alpha Thalassemia Hyposplenism and Splenectomy

17. Cabot ring They are literally loop ,rings or figure 8 types structure that are located with in the cytoplasm of RBC. They are typically colored red purple under the Wright stain They are quite rare They are simple microtubular remnants of mitotic tubules that are involve in mitosis

18. DISEASES ASSOCIATED WITH CABOT RING MYELODYSPLASTIC SYNDROME MEGALOBLASTIC ANEMIA LEAD POISONING HEAVY METAL POISONING LIVER DISEASES

19. DIGNOSIS RARE CONDITION CHECK THE MORPHOLOGY OF RED BLOOD CELL

20. Basophilic Stippling Basophilic stippling is also referred to as  punctuate *dots* basophilia Diseases Associated:  can be divided into 1 fine basophilic stippling   polychromatophilia. 2 coarse *rough* basophilic stippling .  lead poisoning, and thalassemia  impaired hemoglobin synthesis Stained by Wright stain