While visible on a Wright's stained smear, Pappenheimer's bodies should be confirmed with an iron stain, such as a Prussian blue stain. The image on the right is a Prussian blue stain confirming the presence of the Pappenheimer bodies. Wright stain does not stain the iron but rather the protein matrix that contains the iron.
Pappenheimer bodies are seen in certain types of anemia characterized by increased iron storage, such as sideroblastic anemia and thalassemia. These inclusions are also seen in the peripheral blood following a splenectomy. In a healthy person with a normal spleen, Pappenheimer bodies are destroyed before the erythrocytes enter the peripheral circulation.
