Spur Cell Anemia Treatment & Management
- Author: Christopher D Braden, DO; Chief Editor: Emmanuel C Besa, MD more...
Anemia can be corrected by red blood cell transfusion. However, the transfused cells become acanthocytic, with shortened life span in the circulation.
Patients with acanthocytosis should abstain from alcohol use. Abstinence from alcohol use may result in the nearly complete disappearance of acanthocytes in the peripheral blood in patients with mild to moderate alcoholic liver cirrhosis. Abstinence from alcohol is also the best preventive measure for spur cell anemia.
Treatment in cases of acanthocytosis is directed at the underlying disease. Supportive care for patients with reversible liver disease is the mainstay of treatment.
Patients with abetalipoproteinemia may benefit from dietary measures that include triglyceride restriction and lipid-soluble vitamin supplementation.
Genetic counseling is offered to families of patients with abetalipoproteinemia and chorea-acanthocytosis syndromes. The poor general status of acanthocytic patients limits the use of surgical care. Three cases of spontaneous resolution of spur cell anemia following orthotopic liver transplantation have been reported.
Splenectomy may improve the hemolytic anemia. However, these patients are severely ill and, in most cases, cannot undergo surgery.
Doll DC, Doll NJ. Spur cell anemia. South Med J. 1982 Oct. 75(10):1205-10. [Medline].
Haruta I, Hashimoto E, Kabutake A, et al. Spur cell anemia associated with a cirrhotic non-alcoholic steatohepatitis patient. Hepatol Res. 2007 Jun. 37(6):482-5. [Medline].
Alexopoulou A, Vasilieva L, Kanellopoulou T, Pouriki S, Soultati A, Dourakis SP. Presence of spur cells as a highly predictive factor of mortality in patients with cirrhosis. J Gastroenterol Hepatol. 2014 Apr. 29 (4):830-4. [Medline].
Shohet SB, Ness PM. Hemolytic anemias. Failure of the red cell membrane. Med Clin North Am. 1976 Sep. 60(5):913-32. [Medline].
Cooper RA. Hemolytic syndromes and red cell membrane abnormalities in liver disease. Semin Hematol. 1980 Apr. 17(2):103-12. [Medline].
Cynamon HA, Isenberg JN, Gustavson LP, Gourley WK. Erythrocyte lipid alterations in pediatric cholestatic liver disease: spur cell anemia of infancy. J Pediatr Gastroenterol Nutr. 1985 Aug. 4(4):542-9. [Medline].
Olivieri O, Guarini P, Negri M, et al. Increased proteolytic activity of erythrocyte membrane in spur cell anaemia. Br J Haematol. 1988 Dec. 70(4):483-9. [Medline].
Arienti G, Carlini E, Scionti L, Puxeddu E, Brunetti P. Liver alcoholic cirrhosis and spur-cell (acanthocytic) anaemia. A study of erythrocyte ghost composition and fluidity. Scand J Gastroenterol. 1995 Dec. 30(12):1204-9. [Medline].
Kok VC, Lee CK, Horng JT, Lin CC, Sung FC. Reappraisal of the etiology of extracorpuscular non-autoimmune acquired hemolytic anemia in 2657 hospitalized patients with non-neoplastic disease. Clin Med Insights Pathol. 2014. 7:11-4. [Medline].
Marks PW. Hematologic manifestations of liver disease. Semin Hematol. 2013 Jul. 50(3):216-21. [Medline].
Wong P. A basis of the acanthocytosis in inherited and acquired disorders. Med Hypotheses. 2004. 62(6):966-9. [Medline].
Redman CM, Russo D, Lee S. Kell, Kx and the McLeod syndrome. Baillieres Best Pract Res Clin Haematol. 1999 Dec. 12(4):621-35. [Medline].
Terada N, Fujii Y, Ueda H, et al. Ultrastructural changes of erythrocyte membrane skeletons in chorea-acanthocytosis and McLeod syndrome revealed by the quick-freezing and deep-etching method. Acta Haematol. 1999 Mar. 101(1):25-31. [Medline].
Chitale AA, Sterling RK, Post AB, et al. Resolution of spur cell anemia with liver transplantation: a case report and review of the literature. Transplantation. 1998 Apr 15. 65(7):993-5. [Medline].