Transcription
Heinz bodies and bite cells: this is the topic of today's video. So, in my previous video on G6PD deficiency, I've told you about Heinz bodies—these denatured hemoglobin inclusions that get destroyed by the splenic macrophages. It takes this piece out and leaves you with a bite cell. This is so funny; just remember our falafel story from the last video. So, falafel, G6PD deficiency, five-ism, and you end up with bite cells. Doctors are hungry when they are trying to come up with names.
So what are these Heinz bodies? Inclusions of damaged or denatured hemoglobin in the red blood cells. Heinz bodies are considered a signature that the red blood cell has been exposed to oxidative damage—reactive oxygen species such as hydrogen peroxide. If you remember my previous video, let's talk again about falafels. Oxidative agents can damage your red blood cells with free radicals or reactive oxygen species (ROS). But G6PD will produce the amazing NADPH to reduce the glutathione and protect you from this radical damage. So when you see Heinz bodies, it's a signature that the red blood cell has been exposed to oxidant damage.
Okay, with Romanowski stain, which is used to stain blood films, you will not see Heinz bodies; you will just see something that looks like an unevenly colored red blood cell—unevenly distributed hemoglobin. We call it a hemi-ghost or bizarre poikilocytosis. This is the shape; yet normally shaped cells with a supra-vital stain such as methyl violet, you can see nice Heinz bodies. That's great. These are denatured particles of hemoglobin. These Heinz bodies are supposed to be removed by splenic macrophages, yielding bite cells. So the macrophage will come, will bite this Heinz body out of the red blood cell, and you end up with something called bite cells.
Okay, in which conditions can we see Heinz bodies? A lot of them: NADPH deficiency, as well as G6PD deficiency (because G6PD deficiency will lead to NADPH deficiency), as well as chronic liver disease, also hyposplenism. But pay attention: hyposplenic—yes, you can find Heinz bodies, but you will never find bite cells. When you find bite cells, that means you have a normal spleen capable of biting the Heinz body out of the red blood cell.
That's it for today; pretty simple. Please subscribe to my channel to get new videos every single week.