Severe Prolongation of the INR in Spur Cell Anemia of Cirrhosis: True-True and Related?

Spur cells and spur cell anemia in hospitalized patients with advanced liver disease: Incidence and correlation with disease severity and survival

“…Patients with SCA usually have markedly prolonged INR, which is a component of both Child–Pugh and MELD scores and this was also observed in our study. In a report by Sundaram et al ., 45 this association was explained by the alteration of the phospholipid components of thromboplastin reagents that affect both prothrombin time and partial thromboplastin time. This alteration is the hallmark of SCA and can result also in accumulation of cholesterol in platelet membranes leading to abnormal platelet morphology and inability to form clots.…”

Presence of spur cells as a highly predictive factor of mortality in patients with cirrhosis

“…Spur‐cell morphological abnormality is reversible in a non‐cirrhotic microenvironment and is resolved after liver transplantation . The presence of SCA in liver cirrhosis has been associated with advanced disease and poor prognosis . Nevertheless, the exact impact of the presence of SCA on mortality is poorly documented.…”

Spur cell anemia related to alcoholic liver cirrhosis managed without liver transplantation: a case report and literature review

“…Vassiliadis et al reported a 25-day median survival rate in the 9 patients with SCA, and only one patient, who had undergone liver transplantation, had survived after 1 year [12]. To our knowledge, there have been 24 case reports on 26 patients with SCA since 1983 including our case (Table 3) [13,14,16,19,20,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]. On reviewing these cases, the average age was 42.6 years old, and 14 (53.8%) of the 26 patients were men.…”