Spur cell anemia.

The clinical and laboratory findings in eight patients with spur cell anemia are presented and compared with other cases gathered from the literature. Although there is no specific clinical or laboratory abnormality, the condition can be recognized by a constellation of findings. The majority of patients have a long history of ethanol abuse with clinical and laboratory manifestations of hepatocellular dysfunction. All patients have anemia, a reticulocyte count usually greater than 5%, and indirect hyperbilirubinemia. The sine qua non for the diagnosis of spur cell anemia is an increased percentage (usually greater than 20%) of acanthocytes on a peripheral smear. The prognosis of spur cell anemia is poor, the majority of patients dying within a year. From our study, spur cell anemia appears to be more prevalent than is generally reported.