Key result
Alterations in RBC membrane lipid content did not correlate with RBC survival, except in approximately 3% of patients with severe hepatocellular disease and 'spur' cells who had premature cell removal.
Observational
In patients with liver disease, altered RBC lipid content does not generally correlate with RBC survival, except in the small subset with 'spur' cell anemia where increased membrane cholesterol without increased phospholipids leads to premature cell removal.
Altered RBC lipids should not guide hemolysis assessment in most liver disease; leaves open mechanisms specific to spur cell anemia.
The relationship of red blood cell (RBC) membrane lipid content to RBC morphology and survival was studied in patients with liver diseases. An increase in RBC cholesterol and phospholipid was detected in most patients with hepatocellular disease or cholestatic jaundice but the alteration in RBC lipid content did not correlate with RBC survival. The main abnormality of RBC morphology observed was the presence of macrocytes and target cells. In a small proportion of patients (approximately 3%) with severe hepatocellular disease, significant numbers of severely deformed ("spur") cells were seen. In these patients haemolysis was moderately severe and the RBC lipid profile showed increased membrane cholesterol without a concomitant increase in phospholipids. It is concluded that only in patients with "spur" cell anaemia do the morphological alterations lead to premature removal of cells from the circulation. The cause of the shortened RBC survival in jaundiced patients without "spur" cells remains to be determined.
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Powell et al. (1975) conducted an observational in liver diseases. RBC membrane lipid content was evaluated on RBC morphology and survival. Alterations in RBC membrane lipid content did not correlate with RBC survival, except in approximately 3% of patients with severe hepatocellular disease and 'spur' cells who had premature cell removal.
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