Abstract
Liver cirrhosis (LC) is often associated with several hematologic complications, in which anemia is a common feature. Although the exact mechanism of anemia remains controversial, impaired erythrocyte filterability and subsequent hemolysis have been suspected as the causes of anemia associated with LC. We have investigated erythrocyte filterability in relation to the severity of LC. The severity was assessed according to the Child-Pugh classification (grade A, B, and C). The mean erythrocyte filterability of the entire 31 patients with LC (64.6 ± 14.5%) was significantly (P<0.03) decreased compared with that in 5 normal controls (80.5 ± 1.7%). Comparing with the filterability in the controls, the filterability in the LC groups in grade A (70.9 ± 9.6%) was not significantly decreased (p=0.053, n=8), but the filterability in the LC groups in grade B (65.9 ± 11.0%: p < 0.01, n=19) and in grade C (45.9 ± 23.8%: p < 0.02, n=4) were markedly decreased. We found that the impaired filterability reflects the severity of anemia and liver dysfunctions, suggesting that the impairment is one of the causes of anemia. Further, the present study suggested that the impaired filterability arises from the altered erythrocyte membrane properties and a possible mechanical stress due to the accelerated portal hypertension, thus reflecting disorders of the microcirculation.
