Spur cell anemia related to alcoholic liver cirrhosis managed without liver transplantation: a case report and literature review

Clin J Gastroenterol. 2020 Oct;13(5):882-890. doi: 10.1007/s12328-020-01142-3. Epub 2020 May 29.

Abstract

Spur cell anemia is an acquired hemolytic anemia associated with liver cirrhosis and is characterized by the presence of increased large red blood cells, which are covered with spike-like projections that vary in width, length, and distribution. A 26-year-old man was referred to our hospital presenting with jaundice, lower limb edema, and dyspnea. The patient was subsequently diagnosed with spur cell anemia related to alcoholic liver cirrhosis. Spur cell anemia is an independent predictor of mortality in liver cirrhosis and has been associated with extremely poor prognosis. The most effective treatment for spur cell anemia is liver transplantation. As seen in the literature, the treatment of spur cell anemia without liver transplantation is quite challenging. This report highlights the importance of management and treatment strategies, including control of fluid retention, blood transfusion, plasma diafiltration, and administration of diuretics. Our treatment strategies might be useful in patients who are not candidate of liver transplantation or patients waiting for liver transplantation.

Keywords: Alcoholic liver cirrhosis; Case report; Liver cirrhosis; Plasma diafiltration; Spur cell anemia.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Anemia, Hemolytic*
  • Humans
  • Liver Cirrhosis / complications
  • Liver Cirrhosis, Alcoholic / complications
  • Liver Transplantation*
  • Male
  • Prognosis