Sickle cell anemia is a genetic condition that affects the blood, causing the red blood cells to become hard and sickle-shaped, posing a great risk to the patients. Howell-Jolly bodies (HJBs) which are nuclear remnants or small remnants of DNA left after cell division, are often seen in the red blood cells of patients with sickle cell anemia. This article seeks to explain the mystery behind the Howell-Jolly bodies in sickle cell anemia and answer some common questions that may occur about it.
What are Howell Jolly Bodies?
In healthy humans, the spleen plays an essential role in the removal of old and damaged red blood cells (RBCs). However, patients with sickle cell anemia have a shortage of healthy red blood cells, and their spleen may not work correctly. When the patients’ spleen malfunctions, they can develop Howell-Jolly bodies. These small remnants of DNA are usually removed by a healthy spleen, but in sickle cell anemia cases, the spleen is ineffective at doing so.
What Causes Howell-Jolly Bodies in Sickle Cell Anemia?
The shortage of healthy red blood cells caused by sickle cell anemia forces the body to compensate by creating new ones more quickly. These newly produced red blood cells still have remnants of DNA left over from their production. Normally, a healthy spleen eliminates any remaining DNA in these red blood cells, leaving no trace of the Howell-Jolly Bodies. However, patients with sickle cell anemia have a poor functioning spleen, which leads to the Howell-Jolly bodies being present in their blood.
How Do You Identify Howell-Jolly Bodies in Sickle Cell Anemia?
The identification and counting of red blood cells with Howell-Jolly Bodies in sickle cell anemia are carried out using blood smears or thin blood films. The films are stained using dyes that affect the nuclear remnants, making them easily recognizable under the microscope. The Howell-Jolly bodies look like small, dark, round spots inside the red blood cells.
What is the Significance of Howell-Jolly Bodies in Sickle Cell Anemia?
Howell-Jolly bodies are of great significance to the diagnosis of sickle cell anemia, mainly because of their connection to the spleen. If a patient with sickle cell anemia has Howell-Jolly bodies, it is likely that the spleen is not functioning correctly, and the patient is at high risk of developing severe infections. Having Howell-Jolly bodies is not always an indication that the spleen is not functioning correctly. It is, however, an excellent warning signal that signals the need for frequent check-ups and antibiotic prophylaxis for the patient.
What are the Complications of Howell-Jolly Bodies in Sickle Cell Anemia?
If a patient has a high number of Howell-Jolly bodies, it indicates that they have an ineffective spleen. The spleen’s ineffectiveness puts the patients at a higher risk of contracting infections. The spleen plays a major role in controlling and removing bacteria from the bloodstream, and therefore, patients with Howell-Jolly bodies are more susceptible to bacterial infections such as pneumonia and meningitis. The development of Gallstones is also common among sickle cell patients with Howell-Jolly bodies.
How are Howell-Jolly Bodies in Sickle Cell Anemia Treated?
Are there any Specific Treatments for Howell-Jolly Bodies?
There is no specific treatment for Howell-Jolly Bodies, but identifying their presence in sickle cell anemia patients is significant. Recently, treatment has been focused on antibiotic prophylaxis, a preventive course of antibiotics given to patients at risk. Regular follow-ups and monitoring are essential for sickle cell patients, and in some cases, a blood transfusion may be required.
How Can Patients with Howell-Jolly Bodies in Sickle Cell Anemia Avoid Complications?
Sickle cell patients should avoid triggers such as extreme cold or heat, high altitudes, dehydration, and exposure to infections. Patients can take preventive steps such as maintaining cleanliness and avoiding large crowds to prevent infection. Vaccinations are essential, and a yearly flu shot is recommended for sickle cell anemia patients, although it is not 100% effective.
Conclusion
Howell-Jolly bodies is a phenomenon prevalent in sickle cell anemia patients, and it points to an ineffective spleen. Sickle cell patients must regularly monitor their health condition, and regular checkups and monitoring will enable early detection of complications. Patients with Howell-Jolly bodies in sickle cell anemia must take every precaution to avoid triggers that could lead to more serious infections.
References
- Sickle Cell Anemia.
- Basavakumar, Achyut et al.
- “Howell-Jolly bodies in sickle cell anemia: a snapshot.”
- Nature Reviews Hematology vol. 15,6 (2018): 345-346. doi:10.1038/s41575-018-0028-8
- Lutz, Michael.
- “Sickle cell Anemia pathophysiology”.
- MedScape.https://emedicine.medscape.com/article/205926-overview
Frequently Asked Questions about Howell Jolly Bodies in Sickle Cell
- What are Howell-Jolly Bodies?
- Howell-Jolly bodies are small nuclear remnants or small remnants of DNA that are made in the bone marrow of patients with sickle cell anemia.
- Do all patients with sickle cell anemia have Howell-Jolly bodies?
- No, not all sickle cell patients will have Howell-Jolly bodies. Their presence is associated with patients with an ineffective spleen due to sickle cell anemia.
- Is the presence of Howell-Jolly Bodies in Sick Cell Anemia Patients an indication of severe infections?
- No, the presence of Howell-Jolly bodies does not always indicate that the patient has a severe infection, but it is an excellent diagnostic tool for the condition of the spleen.
- Can anything other than sickle cell anemia cause the presence of Howell-Jolly bodies?
- Yes, besides sickle cell anemia, Howell-Jolly bodies can occur in patients with other blood disorders, those that have undergone spleen removal or those with weak spleens due to other health conditions.
- Is there a treatment specifically for Howell-Jolly bodies in sickle cell anemia?
- There is no specific treatment for Howell-Jolly bodies in sickle cell anemia, but identifying their presence is crucial for the patient’s health and preventing severe infections.