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The Significance of the Acanthocyte in Cirrhosis with Hemolytic Anemia.

Charles C. Douglass, M.D.; Rolland C. Reynolds, M.D.; and Eugene P. Frenkel, M.D., F.A.C.P.
Ann Intern Med. 1968;68(5):1167. doi:10.7326/0003-4819-68-5-1167_2
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Three patients with cirrhosis and a hemolytic anemia characterized by acanthocytes or "spur cells" have been studied. Data on the first case have been reported. Extensive in vitro studies reveal variable abnormalities: thus, only in one patient was noted increased autohemolysis that was not accentuated by ethylenediaminetetraacetic acid and was corrected by the addition of adenosine triphosphate (ATP) and accentuated by the addition of ouabain; transformation to a normal biconcave cell was achieved by increased albumin concentration in one and by added ATP in another; erythrocyte ATP levels were low in one patient. By contrast, in no patient could a


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