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Heinz Bodies

Heinz Bodies for Hemoglobin H Inclusions, Hemoglobin H, HB

Test Codes

EPIC: LAB6265, Beaker: XHNZB, ARUP: 49090

Department

Send Outs

Instructions

• Due to specimen stability, samples must arrive in Send Out Laboratory by 12:00 pm on the day of collection, Monday – Thursday only. Specimens can only be collected Monday – Thursday.
  
• This test will not be run on infants under 6 months of age.

Specimen Collection Criteria

Collect (preferred specimen): One Lavender-top EDTA tube.

Also acceptable: One Dark Green-top Sodium or Lithium Heparin tube.

Specimens can only be collected Monday – Thursday.

Physician Office/Draw Specimen Preparation

Do not centrifuge. Do not freeze specimen. Maintain whole blood refrigerated (2-8°C or 36-46°F) until transport. Courier Services must be contacted for a STAT pickup at 1-800-551-0488.

Preparation for Courier Transport

Transport: 5.0 mL whole blood, refrigerated (2-8°C or 36-46°F). (Minimum: 2.0 mL)

Rejection Criteria

• Centrifuged specimens.
• Room temperature or frozen specimens.
• Samples greater than 96 hours old.
• Specimens drawn from patients under six months of age.
• Specimens not collected and processed as indicated.

In-Lab Processing

Do not centrifuge. Do not freeze specimen. Maintain whole blood refrigerated (2-8°C or 36-46°F) until transport. Courier Services must be contacted for a STAT pickup at 800-551-0488.

Transport: 5.0 mL whole blood, refrigerated (2-8°C or 36-46°F). (Minimum: 2.0 mL)

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): Unacceptable
Refrigerated (2-8°C or 36-46°F): 96 hours
Frozen (-20°C/-4°F or below): Unacceptable

Specimen Storage in Department Prior to Disposal:

Specimen retention time is determined by the policy of the reference laboratory. Contact the Send Outs Laboratory with any questions.

Laboratory

Sent to ARUP Laboratories, Salt Lake City, UT.

Performed

Monday – Friday.
Results available in 2-5 days.

Reference Range

Direct: Negative.
Induced: Normal.

Test Methodology

Supravital Stain.

Interpretation

The presence of Heinz bodies can indicate:

1. The ingestion of a sufficient amount of oxidizing drug or chemical (e.g., phenylhydrazine, chlorate, naphthalene) which overwhelms the normal protective mechanism of the red cell and denatures hemoglobin.
   
2. The ingestion of an aniline-derived drug (e.g., primaquine, sulfanilamide) in individuals with G-6-PD deficiency (or other enzyme deficiencies of the hexosemonophosphate oxidative pathway resulting in decreased reduced glutathione) which renders hemoglobin susceptible to oxidative denaturation.
   
3. The presence of Hemoglobin H or an unstable hemoglobin (Zurich, Koln, Seattle, Gun Hill). Heinz bodies also increase in number after splenectomy.

Clinical Utility

Heinz body staining assists in the diagnosis of oxidizing chemical ingestion, G-6-PD deficiency, alpha thalassemia, and certain unstable hemoglobin conditions.

CPT Codes

85441, 85445.

Contacts

Last Updated

10/10/2023