MRCP UK EXAMINATIONS

Detailed explanation-1: -The staining for Hb H inclusion bodies uses brilliant cresyl blue (BCB) or methylene blue (MB) as an oxidant to denature Hb H as intracellular inclusions.

Detailed explanation-2: -Formation of HbH precipitates within red cells known as HbH inclusion bodies that can be induced by incubation with mild oxidants such as Brilliant Cresyl Blue. Numerous such inclusions in HbH disease and can easily be seen on light microscopy in most of the circulating erythrocytes.

Detailed explanation-3: -Hemoglobin H inclusions can only be visualized with supravital stains and not Wright or Romanowsky stains. With supravital stains, such as Brillian Cresyl Blue, the red blood cells are covered with numerous small, dark blue dots that give the cells a “golf ball” or “raspberry” appearance.

Detailed explanation-4: -Hb H bodies are looked for in patients suspected of having alpha thalassaemia trait, Hb H disease or an unstable haemoglobin. The Hb H inclusion bodies assay is used to confirm the presence of variants in haemoglobinopathy investigations.