Howell-Jolly body counting as a measure of splenic function. A reassessment.
Non-surgical and surgical asplenia predisposes to fatal infections; therefore, simple, non-invasive and repeatable tests for assessing splenic function are required, even in non-specialized medical institutions. Howell-Jolly bodies are the most characteristic peripheral blood abnormality after splenectomy, but their counting is not considered a reliable measure of splenic function. In this study, in a group of splenectomized subjects and of patients with non-surgical hyposplenism, we have compared counting of Howell-Jolly bodies, stained by both the May-Grünwald/Giemsa method and the Feulgen reaction, with pitted cell counting which is considered a reliable technique for the assessment of splenic hypofunction. A significant correlation has been found between Howell-Jolly body counts, stained by either technique, and pitted cell counts (P less than 0.0001). Through Howell-Jolly bodies were never detectable when pitted cell counts fell between 4 and 8%, values consistent with a very mild splenic hypofunction, for pitted cell counts above 8% their increase was always associated with increasing Howell-Jolly body counts. These data suggest that, although pitted cell counting represents a more sensitive method for evaluating splenic function, Howell-Jolly body counting may still be regarded as a simple and reliable technique for identifying and monitoring those cases associated with a real risk of overwhelming infections.
Corazza
G R
GR
Department of Internal Medicine, University of L'Aquila, Italy.
Ginaldi
L
L
Zoli
G
G
Frisoni
M
M
Lalli
G
G
Gasbarrini
G
G
Quaglino
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003034:Coated Pits, Cell-Membrane / Q000473:pathology; D004906:Erythrocyte Count; D004908:Erythrocyte Inclusions / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013154:Spleen / Q000502:physiology*; D013156:Splenectomy