Potential Causes of Anemia in Hepatic Cirrhosis: Short communication

RAZVAN JUGANARU; Ana-Maria Deleanu; Mara Alexandra Moldovan

doi:10.5281/zenodo.10096137

Authors

RAZVAN JUGANARU Spitalul Universitar de Urgenţă Bucureşti, România
Ana-Maria Deleanu Spitalul Clinic „Theodor Burghele”, Bucureşti, România
Mara Alexandra Moldovan Spitalul Universitar de Urgenţă Bucureşti, România

DOI:

https://doi.org/10.5281/zenodo.10096137

Keywords:

anemia, , liver cirrhosis, esophageal varices, hemorrhoids, vascular fragility, hypertensive portal gastropathy, thrombocytopenia,, coagulopathy, vitamin K deficiency, splenomegaly, splenic rupture, splenectomy, erythropoietin, thrombopoietin, hepatorenal syndrome, myelodysplastic syndrome, cryoglobulins, amyloidosis, chronic inflammation, iron deficiency, copper deficiency, zinc, lead, vitamin B1, vitamin B2, vitamin B6, vitamin B9, vitamin B12, folic acid, vitamin C, vitamin E, tocopherol, autoimmune hemolytic anemia, microangiopathic hemolytic anemia, Zieve syndrome, acetaldehyde, ring sideroblasts, macrocytes, microcytes, spherocytes, echinocytes, hypochromia, acanthocytes, schizocytes, liver transplantation, hepatic stellate cells, heme synthesis, delta-ALA Dehydratase, delta aminolevulinic acid dehydratase, delta-ALAS, delta aminolevulinic acid synthase, ferrochelatase, spontaneous bacterial peritonitis, Avatrombopag, Lusotrombopag, Eltrombopag, coagulation factors, plasminogen, hemostatics, adrenostasin, etamsylate, tranexamic acid, recombinant, parvovirus B19, malabsorption, emulsification, choleretic, cryoprecipitate, fresh frozen plasma, dysfibrinogenemia, thrombophilia, hyperhomocysteinemia, vaccination, Streptococcus pneumoniae, Neisseria meningitis, Hemophilus influenzae, clarithromycin, proton pump inhibitors, hyperviscosity, Waldenstrӧm macroglobulinemia, immunomodulator, intestinal flora, ADAMTS13, rheumatoid factor, lysophosphocholine-acyl-transferase, coproporphyrinogen oxidase, Prussian blue, NO, nitrogen monoxide, TTP, thrombotic thrombocytopenic purpura, APLS, antiphospholipid syndrome, SOD, superoxide dismutase, TIPS, transjugular intrahepatic portosystemic shunt, deep vein thrombosis, VWF, von Willebrand factor, dimercaptosuccinic acid, succimer, D-penicillamine, midodrine, octeotride, telmipressin, vasopressin, norepinephrine, norfloxacin, biseptol, Congo red, hepcidin, transferrin, ferrireductase, ferroportin, beer, dentures, metallothionein, hemodialysis, hefaestin, ferrioxidase, elemental copper, copper gluconate, optic neuritis, alpha-ceruloplasmin, Coombs test, thermal amplitude of antibodies, biphasic test, Donath-Landsteiner, paroxysmal cold hemoglobinuria, PNH, paroxysmal nocturnal hemoglobinuria, syphilis, agglutination, caplacizumab, rituximab, pentad, tetrad, triad, dyad, lysolecithin, lysocephalin, glutathione, oxidative stress, pyruvate kinase, anaerobic glycolysis, hereditary spherocytosis, Wilson's disease, Clostridium perfringens, Clostridium welchii, TIA, stroke, Transient Ischemic Accident, Cerebrovascular Accident, amyloid, birefringent

Abstract

The article looks at the basic mechanisms of anemia in patients with liver cirrhosis (bleeding through esophageal varices, hemorrhoids, vascular fragility, hypertensive portal gastropathy, thrombocytopenia, coagulopathy, vitamin K deficiency, splenic rupture, splenic sequestration of red blood cells in splenomegaly) and also the additional mechanisms of anemia in liver cirrhosis (erythropoietin deficiency, renal injury, chronic inflammation, deficiency of trace elements and vitamins, autoimmune hemolytic anemia, microangiopathic hemolytic anemia, Zieve syndrome). Depending on the Child-Pugh staging of liver cirrhosis, as well as the associated pathologies of the patient with liver cirrhosis, it is possible that there are simultaneously several ways of the appearance of anemia. It is an attempt to achieve more than a simple review of them in a tabular form, focusing not only on physiopathology, but also on diagnostic and therapeutic elements - the latter being briefly mentioned in widely known situations and presented in more detail in the context of the rarer causes of anemia in patients with liver cirrhosis. In conclusion, the differential and positive diagnosis of anemia in liver cirrhosis decisively influences the therapeutic decision and, of course, not only survival, but also the patient's quality of life. Interdisciplinary collaboration (family doctor, gastroenterologist, internist, infectious disease specialist, hematologist, surgeon, ICA, medical imaging, laboratory) is the optimal way to a diagnosis and targeted treatment of the causes of anemia in liver cirrhosis.

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