Abstract
A 49 year-old male with severe hepatic failure and hemolytic anemia associated with striking acanthocytosis is described. For about 30 years he had a heavy alcohol intake. Physical examination revealed intense jaundice, ascites, splenomegaly and hemolytic anemia with spur-shaped red blood cells. The peculiar spur cells of this disorder are so named because of their "burr", "spiculated" morphology.
Hemolytic anemia with "alcoholic" cirrhosis of the liver was diagnosed clinically. Severe hemolytic anemia persisted for about 4 months despite therapy with steroid hormone and the patient lapsed into hepatic coma and died.
The cause of the spur cell formation is unknown. However it is considered likely that spur cell formation and hemolysis may be due to some factors in the patient's plasma.
The pathological specimen of the liver showed micronodular cirrhosis (precirrhotic stage) with cholestasis and no fatty infiltration.
