Heinz bodies, first discovered by Dr. Robert Heinz in 1890 and otherwise known as Heinz-Erlich bodies, are clumps of damaged hemoglobin located on red blood cells. When hemoglobin becomes damaged, it can cause your red blood cells to stop working properly.

Heinz bodies are associated with both genetic and environmental factors and are linked to certain blood conditions, like hemolytic anemia.

In this article, we’ll explore the causes, symptoms, and treatment options for conditions associated with Heinz bodies.

About hemoglobin

All red blood cells, also known as erythrocytes, contain a protein called hemoglobin. Hemoglobin is responsible for carrying oxygen inside of red blood cells around the body.

When hemoglobin is exposed to toxic elements, it can become “denatured,” or damaged. Denatured proteins whose structure has been damaged can’t function like regular proteins and may play a role in the development of certain diseases.

About Heinz bodies

Denatured hemoglobin inside of red blood cells are called Heinz bodies. When viewed under a microscope during blood testing, they’re visible as abnormal clumps that extend from the red blood cells.

Associated blood disorders

While Heinz bodies have been studied in both humans and animals, in humans they’re associated with a handful of red blood cell disorders, including:

Hemolytic anemia is the most common condition caused by Heinz bodies, but not everyone who has Heinz bodies will develop it. Other conditions mentioned above can cause Heinz bodies to show up on lab test results, even without hemolytic anemia.

Heinz bodies are associated with genetic and environmental factors. For example, Heinz bodies in infants can signal congenital red blood cell disorders. Heinz bodies can also be caused by exposure to certain toxic elements.

In an early case study from 1984, a patient experienced Heinz-body hemolytic anemia after ingesting a petroleum-based oil containing cresol.

Other potential toxic elements that can cause Heinz body formation after exposure or ingestion include:

  • maple leaves (primarily in animals)
  • wild onions (primarily in animals)
  • certain drugs, including synthetic vitamin K, phenothiazines, methylene blue, and more
  • certain dyes used for diapers
  • chemicals used for making mothballs

While there are no specific symptoms for Heinz bodies, there are symptoms associated with the underlying causes and in some cases, the underlying exposure.

Thalassemia

Symptoms of thalassemia may include:

  • delayed growth
  • developmental issues
  • bone deformities
  • fatigue
  • jaundice
  • dark urine

Hemolytic anemia

Symptoms of hemolytic anemia may include:

  • skin that’s paler than usual
  • weakness
  • lightheadedness
  • heart palpitations
  • enlarged spleen or liver

G6PD deficiency

Symptoms of G6PD deficiency may include:

  • skin that’s paler than usual
  • dizziness
  • fatigue
  • trouble breathing
  • increased heart rate
  • jaundice

Although exposure to toxic wild plants is a cause of Heinz bodies primarily in animals, certain medications can also cause the production of Heinz bodies in humans.

Medications that may cause Heinz bodies are used to treat a variety of conditions, such as psychosis and methemoglobinemia. There may be no outwards signs of the presence of Heinz bodies in these conditions. Instead, it’s more likely they’d be found during routine blood testing.

The treatment options for hemolytic anemia, thalassemia, and G6PD deficiency are similar. Depending on the severity of the condition, they may include:

For Heinz bodies that have been caused by exposure to certain medications, your doctor may choose to use other medications for your conditions.

In certain cases, alternate medication options may not be available. In this case, you can discuss the best way to prevent the development of hemolytic anemia.

Even though both bodies can be found on red blood cells, Heinz bodies are not the same as Howell-Jolly bodies.

When red blood cells are finished maturing in the bone marrow, they can enter the circulation to begin providing oxygen to the body. As they enter the circulation, they discard their nucleus.

However, in some cases, the nucleus may not be discarded entirely. At this point, the spleen steps in and removes the leftover remnants.

Howell-Jolly bodies are the name for these leftover DNA remnants inside mature red blood cells. The presence of Howell-Jolly bodies usually indicates that the spleen is either not doing its job or isn’t present.

In some cases, Howell-Jolly bodies may also be associated with megaloblastic anemia.

The presence of Heinz bodies on a blood smear test indicates oxidative damage to the hemoglobin in red blood cells.

Conditions associated with Heinz bodies include certain blood conditions, such as thalassemia or hemolytic anemia. Heinz bodies may also be associated with the ingestion of or exposure to toxic substances.

Treatment for Heinz bodies involves diagnosing and treating the underlying cause.

If your doctor has noticed Heinz bodies on your blood testing, you can work with them to find an official diagnosis and treatment for any underlying conditions.