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Howell-Jolly body

Tuesday 20 December 2011

Definition: Howell-Jolly bodies are histopathological findings of basophilic nuclear remnants (clusters of DNA) in circulating erythrocytes. It is named for William Henry Howell and Justin Marie Jolly.

During maturation in the bone marrow erythrocytes normally expel their nuclei, but in some cases a small portion of DNA remains.

This DNA appears as a basophilic (purple) spot on the otherwise eosinophilic (pink) erythrocyte on a standard H&E stained blood smear. These inclusions are normally pitted out by the spleen during erythrocyte circulation, but will persist in individuals with functional hyposplenia or asplenia.

Common causes of asplenia are splenectomy following trauma to the spleen, and autosplenectomy caused by sickle cell anemia.

Ten percent of patients with Coeliac disease also present with splenic atrophy with subsequent Howell-Jolly bodies.

Other causes are radiation therapy involving the spleen, such as that used to treat Hodgkin lymphoma.

Howell-Jolly bodies are also seen in: severe hemolytic anemia, megaloblastic anemia, hereditary spherocytosis, and myelodysplastic syndrome (MDS).

Etiology

- splenectomy following trauma to the spleen
- autosplenectomy caused by sickle cell anemia.
- Coeliac disease (10%) with splenic atrophy
- radiation therapy involving the spleen
- severe hemolytic anemia
- megaloblastic anemia
- hereditary spherocytosis
- myelodysplastic syndrome (MDS).