A 61-year-old man presented with aggressive hepatitis. Howell-Jolly bodies were present in circulating erythrocytes and the spleen failed to accumulate intravenously administered Tc-99 m sulfur colloid. The patient thus demonstrated functional asplenia. He was treated with high doses of steroids. Four years later, Howell-Jolly bodies were no longer present in circulating erythrocytes. In additi...

We present a case of isolated congenital hyposplenism that was discovered after the peripheral smear revealed Howell-Jolly bodies. This case serves as the basis for a review of hyposplenism for the general practitioner.

During the routine examination of sternal marrow smears it was observed that the presence of nuclear fragments in red cell precursors, commonly known as Howell-Jolly bodies, was usually associated with clear evidence of vitamin B12 or folic acid deficiency. Moreover, this seemed to be so even when the megaloblastic transformation of erythropoiesis was not well developed. With further experience...