This post is an answer to the Case – Patient with Cirrhosis and Anemia
A peripheral-blood smear showed red cells lacking central pallor with irregularly distributed surface projections, features that are consistent with acanthocytes, or spur cells (arrowheads), which are seen in liver disease, in abetalipoproteinemia, and after splenectomy.
These findings led to a diagnosis of spur-cell hemolytic anemia, a type of nonimmune hemolysis that occurs in advanced liver disease owing to excess membrane cholesterol in erythrocytes, a condition that portends a poor prognosis. Because of the severity of her liver disease, the patient was transitioned to hospice care and died at home 2 weeks after discharge.
READ MORE: Anemia – Approach and Evaluation
