Images in Clinical Medicine

Kim Eagle, M.D., Editor

Spur Cells

Donald C. Doll, M.D.

N Engl J Med 1995; 333:1183November 2, 1995

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Article

Figure 1 Scanning electron microscopy (×5000) reveals numerous acanthocytes diagnostic of spur-cell anemia in a peripheral-blood specimen from a jaundiced 43-year-old woman with alcoholic cirrhosis and anemia. Several putative factors, including an altered ratio of cholesterol to phospholipid in the erythrocyte membrane, stagnation of sterols on the red-cell membrane, retention of bile acids, and changes in plasma lecithin-cholesterol acyltransferase concentrations, may be involved in the pathogenesis of spur cells.

Kim Eagle, M.D.

Donald C. Doll, M.D.
Harry S Truman Veterans Affairs Medical Center, Columbia, MO 65201