PMID: 11345202May 10, 2001Paper

Successful combination therapy--flunarizine, pentoxifylline, and cholestyramine--for spur cell anemia

International Journal of Hematology
K AiharaT Matsumoto

Abstract

Spur cell anemia, a hemolytic anemia observed in patients with alcoholic cirrhosis, is characterized by unusual erythrocyte morphology and an increased ratio of free cholesterol to phospholipid in the erythrocyte membrane. The prognosis of spur cell anemia is usually extremely poor, however, we describe here a patient with spur cell anemia who was successfully treated with combination therapy consisting of flunarizine, pentoxifylline, and cholestyramine. Initial therapy with flunarizine alone for 6 weeks did not significantly decrease the number of spur cells on peripheral blood smears. So pentoxifylline was added to the regimen. The patient recovered from the anemia, showed remarkable improvement with regard to the hyperbilirubinemia, and the changes were accompanied by a significant decrease in the number of spur cells in peripheral blood smears. To correct the hypercholesterolemia, cholestyramine was added to the regimen, which resulted in a reduction in the serum level of free cholesterol and an increase in the molar ratio of free cholesterol to phospholipid in erythrocyte membrane. However, 6 months later a skin eruption developed that was considered an adverse reaction to the drugs, so the flunarizine and pentoxifylline w...Continue Reading

References

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Citations

Mar 4, 2014·The American Journal of Emergency Medicine·Rushikesh ShahSavio John
Jun 15, 2007·La Revue de médecine interne·J-S BladéJ-P Algayres
Jan 15, 2010·Hepatology Research : the Official Journal of the Japan Society of Hepatology·Themistoklis VassiliadisNikolaos Evgenidis
Apr 16, 2021·Case Reports in Hematology·Gabriella A RaffaJohn J Byrnes

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