Heinz body anemia is a type of hemolytic anemia, which happens when your red blood cells break down faster than your body can replace them. This can make you feel tired and weak.
What are Heinz Bodies?
Heinz bodies are clumps of damaged hemoglobin attached to your red blood cells. Hemoglobin is an important protein made of an iron-containing molecule called heme and a protein called globin. Hemoglobin carries oxygen through your body.
It’s not fully clear how Heinz bodies form, but the red blood cells have changes in their structure. With these changes, heme can’t join properly with globin and the hemoglobin becomes unstable and damaged.
These damaged hemoglobins attach to your red blood cells, which become stiff instead of soft and break in your spleen. Your spleen removes the Heinz bodies, which leaves your blood cells with a missing section. These are called bite cells.
Your body will break down these damaged blood cells. If this happens faster than your body can replace them, you can get anemia. This is called Heinz body hemolytic anemia or Heinz body anemia.
Causes of Heinz Body Anemia
The main reason Heinz bodies form is because of toxic injury from free radicals or chemicals that damage your blood cells. This is called oxidative damage. Heinz bodies are also linked with some blood disorders.
Oxidative damage that leads to Heinz bodies can be acquired or congenital. Acquired means you get it after birth, while congenital means you are born with a condition that can cause it.
Acquired Heinz body hemolytic anemia comes from:
Medications or chemicals. Exposure to some medications and chemicals can lead to Heinz bodies.
These include:
- Acetaminophen (Tylenol)
- Vitamin K1
- Phenothiazines
- Methylene blue
- Sulfacetamide
- Some chemicals used as dyes
- Some chemicals used to make mothballs
A 1984 report shows that a patient developed Heinz body anemia after swallowing 100 milliliters of a solvent made partly of cresol.
Mineral deficiency. Selenium is an important mineral that helps your body make an antioxidant called glutathione. Glutathione helps protect your red blood cells from free radicals. A lack of selenium can lead to Heinz bodies forming.
Congenital Heinz body hemolytic anemia comes from other disorders you’re born with, including:
G6PD deficiency. This condition is known as glucose-6-phosphate dehydrogenase deficiency. People who have this condition don’t have enough of this G6PD enzyme. It changes into important antioxidants in your body that protect red blood cells.
Most people don’t have any symptoms or problems until they are exposed to some drugs, fava beans, or have an infection. These factors can cause Heinz bodies and red blood cell breakdown, leading to anemia.
Thalassemia. This blood disorder is an inherited genetic condition where your body doesn’t make enough hemoglobin, which causes anemia. Heinz bodies are associated with thalassemia.
Unstable hemoglobinopathies. Some people inherit irregular types of hemoglobin, which cause Heinz bodies to form. These include types like hemoglobin Koln and hemoglobin Zurich.
Heinz Body Anemia Symptoms
Heinz bodies themselves don’t cause any symptoms. If too many of your red blood cells break down, you will get Heinz body hemolytic anemia, which can make you sick.
Symptoms of this include:
- Yellowing skin
- Tiredness
- Trouble breathing
- Pale skin
- Irregular heartbeat
- Swollen liver
- Swollen spleen
Heinz bodies are linked with other blood disorders that cause anemia but also might have different symptoms.
Diagnosis & Tests
If you have symptoms of anemia, your doctor will run some blood tests.
This will usually include:
- Complete blood count, called a CBC, which measures the number of blood cells and platelets you have
- Hemoglobin and hematocrit that measures the number of red blood cells and hemoglobin
- Urine test that looks for hemoglobin in your pee
- Peripheral blood smear to look at the size and shape of your blood cells
The specific blood smear that shows Heinz bodies is called a Heinz body blood smear or Heinz body stain.
Treatment for Heinz Body Anemia
Your doctor might recommend different treatments for Heinz body hemolytic anemia.
These might include:
- Stopping the medication that’s causing problems
- Taking supplements for a deficiency like a selenium vitamin
- Antibiotics
- Intravenous immune globulin
- Blood transfusion
- Immune suppressing medicines
- Spleen removal
- Stem cell transplant
If your medication causes the anemia, don’t stop it until you talk to your doctor. They can find a better replacement for you if you still need treatment.
Complications of Heinz Body Hemolytic Anemia
You can have complications with Heinz body anemia, but it depends on the cause and sometimes the treatment.
Complications can include:
- Blood clots, especially in your lungs
- Gallbladder stones
- Kidney failure
- Heart failure
- Shock
- Side effects from medications
Some of these complications are emergencies. Go to the hospital or call your doctor if you are feeling unwell.