An Unusual Case of Hemolytic Anemia Reversed with Liver Transplantation

Vatsala Katiyar; Apaar Dadlani; Ishaan Vohra; Kamila Cisak; Ashutosh Barve

doi:10.18502/ijhoscr.v16i2.9206

Vatsala Katiyar Division of Medical Oncology and Hematology, Department of Internal Medicine, James Graham Brown Cancer Center, University of Louisville School of Medicine, Louisville, KY
Apaar Dadlani Department of Internal Medicine, University of Louisville School of Medicine, Louisville, USA
Ishaan Vohra Division of Gastroenterology, Hepatology and Nutrition, University of Illinois College of Medicine Peoria, Peoria, USA
Kamila Cisak Division of Medical Oncology and Hematology, Department of Internal Medicine, James Graham Brown Cancer Center, University of Louisville School of Medicine, Louisville, KY
Ashutosh Barve Division of Gastroenterology, Hepatology and Nutrition, University of Louisville School of Medicine, Louisville, USA

DOI: https://doi.org/10.18502/ijhoscr.v16i2.9206

Keywords: Spur cell anemia; Alcoholic cirrhosis; Liver transplant; Zieve's disease; Plasmapheresis

Abstract

Spur cell anemia is acquired hemolytic anemia seen in patients with advanced liver disease, particularly in the setting of alcoholism, and warrants urgent liver transplant evaluation. We describe the case of a 58-year-old female with alcoholic cirrhosis who presented with worsening liver disease, profound anemia poorly responsive to blood transfusions, and multiple spur cells on the peripheral smear. She underwent a liver transplant, which led to the resolution of hematologic abnormalities and the need for transfusions. Our case highlights the significance of spur cell anemia as a harbinger of poor prognosis in patients with advanced liver disease and its reversibility with liver transplantation.