Heinz bodies Howell jolly bodies
  • Inclusions within red blood cells composed of denatured hemoglobin
  • They are formed as a result of oxidative damage or mutations (i.e G6PD)
  • Macrophages in the spleen remove the denatured hemoglobin giving rise to the classic “bite cells” (see below)


  • Nuclear (basophilic) inclusions within RBCs
  • Normally: During maturation, after leaving the bone marrow, erythroblasts’ nuclei are expelled within the spleen
  • HOWEVER, in patients without a spleen (asplenia) secondary to (i.e surgery, radiation or sickle cell disease) will retain these remnants (see below)






  1. Hutchison HE, Ferguson-Smith MA. THE SIGNIFICANCE OF HOWELL-JOLLY BODIES IN RED CELL PRECURSORS. Journal of Clinical Pathology. 1959;12(5):451-453.
  2. Mathew H, Dittus C, Malek A, Negroiu A. Howell-Jolly bodies on peripheral smear leading to the diagnosis of congenital hyposplenism in a patient with septic shock. Clinical Case Reports. 2015;3(8):714-717. doi:10.1002/ccr3.323.
    Winterbourn CC, Carrell RW. Studies of Hemoglobin Denaturation and Heinz Body Formation in the Unstable Hemoglobins. Journal of Clinical Investigation. 1974;54(3):678-689.
    Webster, Stewart. Heinz Body Phenomenon in Erythrocytes. Blood 1949 4:479-497

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