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May-Hegglin anomaly is distinguished from Bernard-Soulier syndrome primarily by the presence of giant platelets and the characteristic inclusion bodies (Döhle-like bodies) in white blood cells in May-Hegglin anomaly, while Bernard-Soulier syndrome is characterized by the absence of specific glycoprotein receptors (GPIb-IX-V complex) on platelets, leading to their inability to adhere to von Willebrand factor. Additionally, May-Hegglin anomaly is often associated with mild thrombocytopenia and does not typically present with bleeding symptoms as severe as those seen in Bernard-Soulier syndrome. Genetic mutations also differ, with May-Hegglin being linked to MYH9 gene mutations and Bernard-Soulier to mutations in the GP1BA, GP1BB, or GP9 genes.

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