1. Hemoglobin H disease. (Peripheral blood, 50 ×
Hemoglobin H disease. (Peripheral blood, 50 ×.) This smear from a patient with severe alpha-thalassemia shows hypochromic, microcytic cells, target cells, and bizarre shapes. These changes are the consequence of loss of three alpha-globin genes. The reticulocyte count is elevated since this is a hemolytic state due to the mispairing of beta-globin units in the marrow compartment. Hemoglobin H is the tetramer of four beta-globin units. Some red blood cells appear normal in this smear because this patient had recently received a blood transfusion. (Used, with permission, from L Damon.)
Source: Blood Disorders, Current Medical Diagnosis & Treatment 2017
Citation: Papadakis MA, McPhee SJ, Rabow MW. Current Medical Diagnosis & Treatment 2017; 2016 Available at: Accessed: October 17, 2017
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