Spur Cell Anemia Treatment & Management

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

Approach Considerations

Treatment in cases of acanthocytosis is directed at the underlying disease.

Complete resolution of spur cell anemia has been reported after liver transplantation. [21] This phenomenon might be attributed to the normalization of lipid metabolism or a decrease in portal hypertension and hypersplenism following transplantation. [2]   

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.

Anemia can be improved by red blood cell transfusion. However, the transfused cells become acanthocytic, with shortened life span in the circulation.

The poor general status of acanthocytic patients limits the use of splenectomy, which can potentially improve hemolytic anemia. However, these patients are severely ill and, in most cases, cannot undergo surgery.

Patients with abetalipoproteinemia may benefit from dietary measures that include triglyceride restriction and lipid-soluble vitamin supplementation.

Because patients with abetalipoproteinemia cannot absorb triglycerides, a diet restricted in these nutrients may significantly improve symptoms. Vitamin E can prevent the progression of the disease in these patients, and supplementation of the diet with lipid-soluble vitamins A, K, E, and D results in further improvement of neurologic and retinal symptoms.

Genetic counseling is offered to families of patients with abetalipoproteinemia and chorea-acanthocytosis syndromes.