Basophilic stippling

Basophilic stippling, also known as punctate basophilia, is the presence of numerous basophilic granules that are dispersed through the cytoplasm of erythrocytes in a peripheral blood smear. They can be demonstrated to be RNA. They are composed of aggregates of ribosomes; degenerating mitochondria and siderosomes may be included in the aggregates.^{[citation needed]} In contrast to Pappenheimer bodies, they are negative with Perls' acid ferrocyanide stain for iron (i.e. no iron in basophilic stippling).^[1] Basophilic stippling is indicative of disturbed erythropoiesis. It can also be found in some normal individuals.^[2]

Blood smear showing red blood cells with basophilic stippling

Associated conditions

• Thalassemia^[3] (β-thalassemia Minor (i.e. Trait) & Major, and α-thalassemia, only when 3 gene loci defective: (--/-α))
• Severe megaloblastic anemia
• Hemolytic anemia
• Sickle-cell anemia
• Pyrimidine 5' nucleotidase deficiency^[4]
• Alcoholism^[5]
• Myelodysplastic syndromes
• Sideroblastic anemia^[6]
• Congenital dyserythropoietic anemia^[7]
• Primary myelofibrosis
• Leukemia^[8]
• Erythroleukemia^[9]
• Hemorrhage, e.g. from gastrointestinal tract
• CPD-choline phosphotransferase deficiency^[10]
• Unstable hemoglobins
• Altered hemoglobin biosynthesis
• Heavy metal poisoning^[11][12]
  • Lead poisoning
  • Zinc
  • Arsenic
  • Silver
  • Mercury