Heinz-Body Anaemia in the Newborn

The association of Heinz-bodies within erythrocytes, extreme distortion of the size and shape of erythrocytes and hemolytic anemia in newborn infants, especially premature infants, has been sporadically reported in the medical literature since 1948. Heinz-bodies are thought to be either remnants of disintegrated membranes of erythocytes or abnormal products of hemoglobin metablism, and are demonstrable only by supravital staining techniques. The present study contributes two case reports and discusses the sequence of the clinical and hematologic manifestations. The first patient was a full-term infant who developed jaundice and symptoms attributable to anemia at 2 weeks of life. The second infant was prematurely born, did not develop jaundice but showed large numbers of Heinz-bodies (70%) as the anemia progressed. Both patients responded well to a single transfusion of packed blood cells, with complete reversal of the abnormal peripheral blood findings. None of the usual causes of hemolysis could be demonstrated by extensive laboratory tests. Agents such as phenylhydrazine, known to produce Heinz-bodies, could not be incriminated. The phenomenon of Heinz-body formation in infants may be more common than is apparent as the technique of demonstration is not commonly a part of the routine study of infants with evidence of hemolytic anemia. This technique is described and illustrations of erythrocytes containing Heinz-bodies are provided.