Hematologic Observations in Patients With Chronic Hepatic Insufficiency

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

“…CIRRHOSIS IS OFTEN associated with chronic anemia. Up to 70% of cirrhotic patients have reduced hemoglobin levels 6–8 . The etiology of anemia in cirrhosis is complex and multifactorial.…”

“…Up to 70% of cirrhotic patients have reduced hemoglobin levels. [6][7][8] The etiology of anemia in cirrhosis is complex and multifactorial. Poor nutritional status, hemolysis due to hypersplenism, gastrointestinal blood loss, vitamin B12 and/or folate deficiency, chronic inflammation, ineffective erythropoiesis due to bone marrow suppression (resulting from direct toxic effect of alcohol or from humoral inhibitors of erythroid progenitor cells) and blunted erythropoietin (epo) response to anemia are among the commonest precipitating factors.…”

Intrahepatic synthesis of immunoglobulin in liver disease

“…These unexpected results could be partially accounted for by the patients with autoimmune CAH having received immunosuppressive treatment or, alternatively, newly synthesized Ig could have become bound to cellular antigens and thus not be detected by our technique. There was a higher plasma cell density in CAH than in AH, and presumably these plasma cells were the source of intrahe-patic Ig production in CAH; however, the source of the high serum Ig could also include regional lymph nodes (10, 18), spleen (18,19), bone marrow (20) and also peripheral blood lymphocytes as shown in cirrhotic hyperglobulinaemia (21) and in alcoholic liver disease in which B cells appeared to be under intense antigenic stimulation in vivo (22). Further evidence for extrahepatic formation of serum Ig is provided by the animal model of parasitic liver infestation, M. corti in mice; only 10% of the total Ig synthesized is from the liver, the rest being produced by the spleen and lymph nodes (10, 19).…”

A New Entity of Antibody Deficiency Syndrome, to Which “Congenital Dysgammaglobulinemia” Might Be Suggested

“…Though the present case, from viewpoint of ganimaglobulin content in serum, is quite different from a case of agammaglobul inemia, both disorders seem to have an immunological similarity in that both are unable to develop antibody. Since plasma cell is thought to be closely associated with production of antibody gamma obulin [21][22][23][24][25][26][27], hypergammaglobulinemia ought to be usually accompanied with increase of plasma cells in the reticuloendothelial system. In the present case, however, there was no expected proliferation of plasma cells either in lymph nodes or bone marrow ; on the contrary, a more or less striking decrease of these cells was seen (Cf.…”