title: Reticulum vs Inclusions: A Learning Experience in Haemoglobin H Disease.
abstract: 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.
authors.affiliation: Assistant Professor, Department of Pathology, Kasturba Medical College Manipal University , Mangalore, Karnataka, India .
authors.forename: Hanaganahalli B
authors.initials: HB
authors.lastname: Sridevi
authors.affiliation: Associate Professor, Department of Biochemistry, Kasturba Medical College Manipal University , Mangalore, Karnataka, India .
authors.forename: Anupama
authors.initials: A
authors.lastname: Hegde
authors.affiliation: Assistant Professor, Department of Medicine, Kasturba Medical College Manipal University , Mangalore, Karnataka, India .
authors.forename: Prashantha
authors.initials: P
authors.lastname: Balanthimogru
authors.affiliation: Associate Professor, Department of Pathology, Kasturba Medical College Manipal University , Mangalore, Karnataka, India .
authors.forename: Urmila N
authors.initials: UN
authors.lastname: Khadilkar
authors.affiliation: Associate Professor, Department of Pathology, Kasturba Medical College Manipal University , Mangalore, Karnataka, India .
authors.forename: Shrijeet
authors.initials: S
authors.lastname: Chakraborti
keywords: Brilliant cresyl blue; Granulofilamentous reticulum; HbH inclusions; High performance liquid chromatography