Why howell jolly bodies

Howell-Jolly bodies are round, smooth, almost pyknotic, dark-purple bodies ranging in size from 0. Howell-Jolly bodies are thought to be nuclear remnants or aggregates of chromosomes that have separated from the mitotic spindle and remain behind after the remainder of the RBC nucleus is expelled. The spleen normally removes these bodies from the RBCs; however, Howell-Jolly bodies can be observed on a Wright-stained peripheral blood smear post-splenectomy or when the spleen is not functioning properly.

Howell-Jolly bodies may also be seen in hemolytic anemias such as sickle cell anemia. Differential diagnosis. Sign up for our Email Newsletters.

Click here for information on linking to our website or using our content or images. Home About Us Advertise Amazon. Telephone: ; Email: CommentsPathout gmail. This website is intended for pathologists and laboratory personnel but not for patients. We welcome suggestions or questions about using the website. This is a picture of a red blood cell with a Howell-Jolly body red arrows. They are left over nuclear remnants that are usually removed when blood cells are in the spleen.

Howell-Jolly bodies occur where there is no spleen or an non-functioning spleen, referred to as asplenia. They are usually one of these at most in a red cell, round, dark purple to red in color and often located peripherally on the red blood cell.

If a patient comes in with sepsis, fever, headache and myalgias, meningitis is very likely. The most common pathogen of meningitis is Streptococcus pneumoniae pneumococcus. This patient is at risk for any bacteria that are encapsulated.

In addition to Streptococcus pneumoniae , this includes Haemophilus influenzae and Neisseria meningitidis. Babesiosis is thought be more common in patients with a non-functioning spleen 3. Well, if you already knew she had meningitis you would already be giving the right antibiotics to cover for Streptococcus pneumoniae , Haemophilus influenzae and Neisseria meningitidis. However, the diagnosis of bacterial meningitis can often be delayed from variations in presentation.

Additionally, in patients presenting with sepsis from other infections, knowing the spleen is missing can be valuable to making sure you are treating for these organisms until cultures become positive or in case you are unable to confirm the bug.

Spherocytes, noted by the lack of a pale center can been seen most commonly in hemolytic anemia and less commonly in hereditary spherocytosis. Larger, more purple reticulocytes see in image will often be seen in hemolytic anemia as the body tries to make more red blood cells. Schistocytes red arrow and helmet cells blue arrow are common in any disease where there is shearing or mechanical destruction of the red cells.

This includes, disseminated intravascular coagulation, thrombotic thrombocytopenic purpura and aortic stenosis. Target cells AKA codocytes appear as bullseyes, as seen here. His thesis was on the origin of fibrin in blood coagulation.

During his work on coagulation, Howell began to observe how granules stained like nuclei. Justin Marie Jolly was born in in Melun, now a Paris suburb, obtaining his doctorate in at the University of Paris. The first report connecting the presence of a Howell-Jolly body to splenectomy was by Schur in The patient in this report suffered from pernicious anemia, hyperthyroidism and whose spleen on autopsy was found to be replaced by fibrous tissue.

She got a lumbar puncture which had an elevated white cell count, consistent with bacterial meningitis with a negative gram stain. After getting hemodynamic support and proper antibiotics she recovered from this infection. It was thought she had a congenital version of asplenia. She was vaccinated for Streptococcus pneumoniae, Haemophilus influenzae and Neisseria meningitidis prior to discharge.

Babesiosis in splenectomized adults. Review of 22 reported cases.