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eFigure 13–2. Alpha-Thalassemia trait. (Peripheral blood, 50 ×.) Mildly hypochromic and microcytic cells with occasional target cells in a patient with alpha-thalassemia trait (the absence of two alpha-globin genes). Note that the red blood cells are slightly smaller than the small lymphocyte nucleus shown in the center of the field. (Used, with permission, from L Damon.)

Current Medical Diagnosis & Treatment 2018 > Blood Disorders

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eFigure 13–3. 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.)

Current Medical Diagnosis & Treatment 2018 > Blood Disorders

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eFigure 13–4. Beta-thalassemia. (Peripheral blood, 50 ×.) Microcytic red blood cells, most of which are target forms, consistent with beta-thalassemia. These target cells are also hypochromic because they contain very little hemoglobin. (Used, with permission, from L Damon.)

Current Medical Diagnosis & Treatment 2018 > Blood Disorders

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eFigure 13–5. Beta-thalassemia major. (Peripheral blood, 50 ×.) Microcytic, hypochromic target cells of severe beta-thalassemia. Many red blood cell shapes are bizarre, consistent with severe thalassemia. There is intense reticulocytosis, as evidenced by a large number of nucleated red blood cells in the peripheral blood. The thalassemias are hyperproductive anemias manifested by hemolysis occurring in the bone marrow compartment due to mispairing of beta and globin units. (Used, with permission, from L Damon.)

Current Medical Diagnosis & Treatment 2018 > Blood Disorders

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eFigure 13–13. Hemoglobin SS disease. (Peripheral blood, 50 ×.) Multiple sickled forms are the consequence of hemoglobin S polymerization. Also present are target cells—a manifestation of either sickle cell hepatopathy or concomitant sickle-beta thalassemia. (Used, with permission, from L Damon.)

Current Medical Diagnosis & Treatment 2018 > Blood Disorders

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eFigure 13–14. Hemoglobin SS disease. (Peripheral blood, 100 ×.) Sickled red blood cells and target cells in a patient with hemoglobin SS disease and sickle hepatopathy. In addition, the red blood cell in the lower central area of the field contains a hard peripheral inclusion called a Howell-Jolly body. This represents nuclear remnants and is the consequence of hyposplenism. (Used, with permission, from L Damon.)

Current Medical Diagnosis & Treatment 2018 > Blood Disorders

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