Spur-Cell Hemolytic Anemia

A woman was referred to our hospital for jaundice, subcutaneous bleeding, and anemia. Biopsy findings confirmed liver failure due to alcoholic cirrhosis. A peripheral-blood smear showed red blood cells with irregularly spaced spur-like projections, which indicated spur-cell hemolytic anemia. Spur-cell anemia is an acquired hemolytic anemia associated with liver cirrhosis. The condition is characterized by the increased presence of large red blood cells covered with spike-like projections that vary in width, length, and distribution. Despite the poor prognosis of spur-cell anemia, supportive measures have been effective for 9 months in this case in anticipation of a liver transplantation.