Pappenheimer Bodies

Small numbers of Pappenheimer Bodies may be seen in normal blood, particularly within polychromatic cells. When they are present in large number look for hyposplenic features, or for pathological states that have iron-loading or aberrant iron metabolism.

Normal Individuals

Normal red cells may contain Pappenheimer bodies, particularly within reticulocytes. These physiological inclusions are removed by the spleen and so are not generally seen in mature erythrocytes.

Pathological (hyposplenism)

Following splenectomy or in hyposplenic conditions
Pappenheimer bodies are not cleared from the circulating cells

Pathological (ineffective erythropoiesis)

Particularly where iron incorporation into haem is disturbed, or when iron loading is excessive
Hemoglobinopathies (thalassemia), sideroblastic anaemia, vitamin B12 deficiency, vitamin B6 deficiency, alcohol excess, anti-pyridoxine therapy, chloramphenicol, mitochondrial disorders