Spur Cell Anemia Differential Diagnoses

Updated: Jun 20, 2021
  • Author: Maham Bakhtyar, MBBS; Chief Editor: Emmanuel C Besa, MD  more...
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Diagnostic Considerations

Echinocytes and keratocytes should be considered in the differential diagnosis of spur cell anemia. Echinocytes or burr cells are spiculated red blood cells with uniform, narrow, spikelike surface projections. Spur cells have fewer spicules, and the spicules vary more in size than echinocytes. Keratocytes are acanthocyte like cells with bizarre shapes and hornlike projections.

Other causes of hemolytic anemia in severe liver disease include the following:

  • Hemolytic anemia with echinocytes
  • Severe hypophosphatemia
  • Splenomegaly-related hemolytic anemia with spherocytosis
  • Zieve syndrome

Differential Diagnoses