spur cell hemolytic anemia

Etiology

• decompensated cirrhosis (Zieve syndrome)

Pathology

• severe liver disease alters lipid metabolism resulting in abnormal lipid in the erythrocyte membrane
• spicules of variable size distribution appear on the erythrocyte membrane
• spiculated erythrocytes are known as acanthocytes (spur cells)
• spur cells are prone to hemolysis

Management

• supportive care
• transfusions as needed
• treatment is directed toward underlying liver disease
• prognosis is poor
  • often correlates with other markers of severe liver disease

More general terms

• hemolytic anemia

Additional terms

• acanthocyte (spur cell)