A Thorny Problem in Cirrhosis

Explore a case of severe anemia in a patient with cirrhosis. See how hemolysis, lab data, and a key finding on the Peripheral Smear reveal the diagnosis.

Spur-cell hemolytic anemia


A 48-year-old woman with advanced cirrhosis presented with fatigue, jaundice, and abdominal distention. Laboratory studies showed a hemoglobin level of 5.8 g per deciliter (reference range, 12.0 to 15.5), a lactate dehydrogenase level of 1219 U per liter (reference range, 125 to 220), a low haptoglobin level, and an elevated reticulocyte count. Coombs’ antiglobulin testing was normal. The result of a peripheral-blood smear is shown. What is the diagnosis?

What is the most likely diagnosis?

Autoimmune hemolytic anemia
Babesiosis
Hypersplenism
Microangiopathic hemolytic anemia
Spur-cell hemolytic anemia

Acanthocytes, Cirrhosis, Data Interpretation, Hemolysis, Spur-cell hemolytic anemia

Leave a Comment