Red cell survival in biliary cirrhosis

Abstract

SYNOPSIS Studies were carried out on eight patients with primary biliary cirrhosis. Four patients were found to have a haemolytic anaemia; one had Coombs red cell antibodies. Two patients had evidence of splenic sequestration of red cells using the radio-chromium technique. There was a significant correlation between the red cell survival and the bromsulphthalein retention test and the red cell survival and the serum level of bilirubin. It was concluded that the anaemia of cirrhosis of the liver, including primary biliary cirrhosis, may be due to a number of mechanisms and a unifying hypothesis based on the degree of liver dysfunction is suggested.

Living Donor Liver Transplantion for Primary Biliary Cirrhosis with Autoimmune Hemolytic Anemia: A Case Report

“…An association between PBC and various other autoimmune conditions has been described [1][2][3][4]. In addition, a decrease in the red blood cell survival time has been well documented in association with all types of cirrhosis, including PBC [1], although the mechanism involved is not clear and may be either intracorpuscular or extracorpuscular [1].…”

“…Hemolysis can be detected in more than half of all patients with cirrhosis, regardless of the etiology [2]. However, little has been published regarding any association between PBC and autoimmune hemolytic anemia (AIHA) or other severe hemolytic states [3].…”

A patient with primary biliary cirrhosis associated with autoimmune hemolytic anemia

“…16 Although the association between various immunologic disorders and PBC has gradually been gaining recognition, only ten cases of PBC associated with AIHA have been reported. [17][18][19][20][21][22][23][24][25][26] AIHA is characterized by a positive direct Coombs' test and is classified as 'warm' or 'cold' type, according to whether the antibody reacts better with red cells at 37°C or at 4°C. Warm antibody hemolytic anemia is idiopathic (primary) in approximately 50% of cases or secondary to medication (eg, methyldopa, quinidine, penicillin), hematological malignancies (chronic lymphocytic leukemia, lymphoma, myeloma), and rheumatological disorders (such as SLE or RA).…”

Primary biliary cholangitis associated with warm autoimmune hemolytic anemia

“…The association between PBC and warm autoimmune hemolytic anemia (wAIHA) is quite rare. To our knowledge, only 20 case reports have been described in the literature . Here we reported a case of PBC‐associated wAIHA.…”