Acanthocytosis secondary to severe liver disease
Introduction
Introduction to erythrocytosis caused by severe liver disease Spinocytosis, which is secondary to severe liver disease, is uncommon and is secondary to advanced stages of alcoholic cirrhosis and other liver diseases. Most patients with chronic liver disease have mild to moderate anemia, and in a small number of patients, especially in the terminal phase of liver disease, anemia can rapidly increase, often accompanied by rapid deterioration of liver function, deepening of jaundice, hepatic encephalopathy, or Patients with major bleeding in the digestive tract often die in a short period of time. basic knowledge The proportion of illness: 0.0006% Susceptible people: no specific population Mode of infection: non-infectious Complications: gastrointestinal bleeding
Cause
The cause of erythrocytosis secondary to severe liver disease
Causes
Found in severe liver disease.
Pathogenesis:
The content of free (ie, non-esterified) cholesterol and phospholipids in normal erythrocyte membranes is equal, free cholesterol in erythrocyte membrane and plasma is constantly exchanged, and it is in dynamic equilibrium, while cholesterol esters cannot be exchanged. In patients with severe liver disease, plasma is free. The ratio of cholesterol to phospholipids is increased, too much free cholesterol infiltrates into the erythrocyte membrane, and the free cholesterol content in the membrane is increased. The mechanism of the formation of the thorn red blood cells is unclear. It is speculated that a large amount of free cholesterol infiltrating into the erythrocyte membrane may accumulate in the lipid bilayer. The membrane surface is expanded to form an irregular shape and target-shaped red blood cells, selectively accumulating more in the outer layer, reducing the fluidity of the outer layer of lipid, and at the same time reducing the deformability of the red blood cells, and the red blood cells are further modified as they pass through the spleen. Some membranes are removed, the morphology tends to be spherical, and a thorn-like protrusion is formed, eventually becoming a spinous cell, and the thorny red blood cells are easily destroyed by the spleen.
Prevention
Prevention of erythrocytosis secondary to severe liver disease
First, liver disease prevention should avoid hepatitis B virus infection.
Second, the prevention of liver disease should limit the amount of alcohol consumption, especially those who cannot be drunk repeatedly. People who have suffered from liver disease must absolutely avoid alcohol.
Third, liver disease prevention should be rationally matched with nutrition: neither nutritional deficiency nor nutrient excess, to reduce the formation of nutritional hepatomegaly and fatty liver. Mildew, spoiled peanuts, corn, fish, shrimp, crab, clams, not to enter.
Fourth, liver disease prevention should be used with caution, not abuse drugs: drugs that are harmful to the liver, if not used, should also shorten the course of treatment; parasitic diseases, heart disease, biliary diseases, early prevention and early treatment. It is a good idea to check the body regularly. It is necessary for the elderly to have a health check every year. At present, there are some health care products on the market, which are often claimed to be liver-protecting products. Care should be taken when selecting them. If necessary, please consult a doctor.
Complication
Complications of erythrocytosis secondary to severe liver disease Complications, gastrointestinal bleeding
Most patients with chronic liver disease have mild to moderate anemia, and in a small number of patients, especially in the terminal phase of liver disease, anemia can be rapidly aggravated, often accompanied by rapid deterioration of liver function, and jaundice is deepened by hepatic encephalopathy or gastrointestinal bleeding. Patients often die in the short term.
Symptom
Symptoms of erythrocytosis secondary to severe liver disease Common symptoms Red blood cell jaundice complexion red
Most patients with chronic liver disease have mild to moderate anemia, and in a small number of patients, especially in the terminal phase of liver disease, anemia can rapidly increase, often accompanied by rapid deterioration of liver function, deepening of jaundice, hepatic encephalopathy, or Patients with major bleeding in the digestive tract often die in a short period of time.
Combined with medical history, clinical manifestations, signs and laboratory tests, it is generally not difficult to diagnose.
Examine
Examination of echinocytosis secondary to severe liver disease
Peripheral blood
A small amount of target red blood cells can be seen, and many spinous red blood cells can be seen (up to 10% to 60%). The anemia is positive cell angiolipemia, and platelets and white blood cells can be reduced.
2. Laboratory tests related to liver function damage.
According to the clinical manifestations, symptoms and signs, B-ultrasound, CT, MRI, electrocardiogram, X-ray and biochemical tests were selected.
Diagnosis
Diagnosis and differentiation of erythrocytosis secondary to severe liver disease
The erythrocyte hemolytic anemia secondary to liver disease is differentiated from the following conditions:
1Zieve syndrome: transient hemolysis associated with hepatic steatosis and hypertriglyceridemia;
2 transient oral red blood cell hemolysis caused by alcoholism;
3 spine erythrocyte hemolysis: seen in patients with dystrophic liver disease with severe hypophosphatemia and hypomagnesemia;
4 Mild spherical red blood cell hemolysis associated with splenomegaly.
