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Updated: Mar 30, 2026

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Reticulum vs Inclusions: A Learning Experience in Haemoglobin H Disease

Hanaganahalli B Sridevi1, Anupama Hegde2, Prashantha Balanthimogru3

  • 1Assistant Professor, Department of Pathology, Kasturba Medical College Manipal University , Mangalore, Karnataka, India .

Journal of Clinical and Diagnostic Research : JCDR
|November 12, 2015
PubMed

Haemoglobin H disease, also known as the alpha-thalassaemia is characterized by the presence of HbH inclusions in red blood cells, detectable on supra-vital stain. We present a case of a previously asymptomatic 31-year-old male, who insidiously developed anaemia and had prominent splenomegaly. Peripheral smear examination revealed microcytic hypochromic anaemia with numerous spherocytes and moderate polychromasia. In reticulocyte preparation with Brilliant cresyl blue, HbH inclusions were mistakenly identified as granulofilamentous reticulum of reticulocytes, giving a spuriously high reticulocyte percentage. After the literature review, repeat assessment was performed and with the aid of high performance liquid chromatography result, it was possible to delineate the HbH inclusions.

Keywords:
Brilliant cresyl blueGranulofilamentous reticulumHbH inclusionsHigh performance liquid chromatography

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