Heinz bodies are insoluble intracellular inclusions of Hb attached to the RBC membrane. Heinz bodies are uncommon except with G-6-PD deficiency immediately after hemolysis and in patients with unstable Hb variants.
Oxidative denaturation of the Hb molecule leads to Heinz body formation and is probably the mechanism for the precipitation of unstable Hb. Heinz bodies are usually removed by the spleen; after splenectomy, they increase in the peripheral blood and may appear in more than 50% of RBCs.
Obtain a 5-mL venous blood sample using either a green-topped (sodium heparin) tube or a lavender-topped (EDTA) tube. Label the specimen with the patient’s name, date and time of collection, and test(s) ordered. Place the specimen in a biohazard bag.
Mix cells with a supravital stain and examine microscopically. They stain as pale blue bodies, as opposed to the dark purple RNA in reticulocytes.
Increased Heinz bodies are found in:
G-6-PD deficiency, especially after hemolysis
Congenital Heinz body hemolytic anemia
Unstable Hb variants (e.g., Hb Zurich, Hb Philly)
Homozygous beta-thalassemia
Heinz bodies are found in blood of normal persons who have been poisoned by certain drugs used in treatment protocols (e.g., chlorates, phenylhydrazine, primaquine).
Heinz bodies are present in some newborns or in patients who underwent splenectomy.
Pretest Patient Care
Explain test purposes and procedures.
Follow guidelines in Chapter 1 for safe, effective, informed pretest care.
Posttest Patient Care
Review test results; report and record findings. Modify the nursing care plan as needed. Counsel the patient regarding abnormal findings; explain the need for possible follow-up testing and treatment.
Follow guidelines in Chapter 1 for safe, effective, informed posttest care.
see Appendix E for drugs that affect test outcomes.