Hematologic Manifestations of Liver Disease

Published on 04/03/2015 by admin

Filed under Hematology, Oncology and Palliative Medicine

Last modified 04/03/2015

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Chapter 69 Hematologic Manifestations of Liver Disease

Andrea Lee, Wendy Lim

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Figure 69-1 RED BLOOD CELL (RBC) MORPHOLOGY IN LIVER DISEASE.

A, Macrocytes have a mean corpuscular volume greater than 100 fL and can be oval shaped. Commonly associated disorders include liver disease and vitamin B12 and folate deficiency. B, Target cells are characterized by the bull’s-eye appearance of the RBC. They are a result of an increased surface-to-volume ratio related to excess RBC membrane (e.g., liver disease) or disproportionate reduction of cytoplasmic content (e.g., hemoglobinopathies, iron deficiency). C, Acanthocytes, or spur cells, typically appear as contracted RBCs lacking central pallor with multiple irregular membrane projections. The morphologic appearance reflects the irreversible cytoskeletal damage that has occurred because of passage of nondeformable RBCs through the reticuloendothelial system. They are most commonly seen in severe liver disease but can also be features of rare neuroacanthocytosis syndromes or lipoprotein disorders.

Hemostatic Indices in Liver Disease

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Clauss, Clauss fibrinogen; DD, D-dimer; DIC,

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