are these the same:heinz bodies,howell jolly bodies,target cells

[felicia2001uk]

any images please?

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[superoxide]

howell jolly bodies: http://www.wadsworth.org/chemheme/heme/glass/slide_005_howell-jolly_bod.htm

heinz bodies: http://images.google.ca/images?q=he...en-US:official&hs=iGx&sa=X&oi=images&ct=title

target cells:
http://images.google.ca/images?svnu...US:official&hs=nGx&q=target+cells&btnG=Search

 

[TheEleventhReel]

Hi Felicia. No, they are not the same thing.

Heinz bodies = G6PD. Heinz bodies are formed b/c peroxide oxidizes Hb (b/c G6PD ppl have a decreased synthesis of GSH). So, the Hb is oxidized and precipitates in the RBC forming a Heinz body.

Howell-Jolley = Sickle Cell Dz. The HJ bodies are nuclear remnants indicating splenic dysfunction (spleen is dysfunctional = splenic Macs can't phagocytize senscent RBCs)

Target cells = Sickle Cell Dz.

Do you have the new RR pathology? If you don't, I'd recommend it. For the most part, it accompanies Goljan's audio files and has lots of pics.

 

[felicia2001uk]

Thanks.I have the first edition RR Path..and STARS path..and Robbins Q book.

 

[TheEleventhReel]

Ok. I haven't seen the first edition, but I'm sure it's fine. The 2nd one is pretty voluminous for a "rapid review" (600 pages of text), but it seems pretty exhaustive. I've been using it instead of big Robbins and been doing well in path classes. Hopefully it'll be golden for USMLE

 

[lord_jeebus]

Target cells = Sickle Cell Dz.

I'll add that target cells are not a very specific finding, and in a boards context would more likely be associated with a thalassemia.

Also (i doubt you'd be tested on this), Howell-Jolly bodies are not due so much to the failure of senescent RBC destruction - the main mechanism is removal of DNA inclusions from young RBCs that have failed to completely extrude their nuclei (the bodies get removed by macrophages while leaving the rest of the RBC intact - I don't know if the exact pitting mechanism is clear)

 

[TheEleventhReel]

Thanks for the correction Jeebus. I was basing my response on what Goljan said about autosplenectomy in sickle cell and that Howell-Jolley bodies were a sign of splenic dysfunction.

 

[UCLAstudent]

Aren't Heinz bodies also seen with alpha thalassemia?

 

[lord_jeebus]

Aren't Heinz bodies also seen with alpha thalassemia?

Yes, they are.

 

[felicia2001uk]

I thought it's target cells in thalassemia but heinz bodies and bite cells in G6PD deficiency.I better pick up STARS ..Goljan

 

[TheEleventhReel]

I didn't know that either. Goljan's RR/audio lecs don't mention Heinz bodies in alpha thal, so I looked it up in Robbins. While Robbins only uses the phrase "Heinz bodies" for G6PD, it does state that HbH (alpha thal) is prone to oxidation which can lead to intracellular accumulation. I guess it's safe to assume that you can also have bite cells in alpha thal?

 

[felicia2001uk]

Really?Now ,we are all Goljanites!we have to get Papa!