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Case Rep Hematol 2021 26;2021:8883335. Epub 2021 Mar 26.

Department of Medicine, Division of Hematology, University of Miami, Miami, FL, USA.

The etiology of anemia in liver cirrhosis is multifactorial; one less recognized cause is hemolytic anemia due to spur cells, known as spur cell anemia. We present the case of a 57-year-old woman with alcoholic cirrhosis who presented with symptomatic macrocytic anemia with a hemoglobin level of 7.4 g/dL and signs of decompensated liver disease. Read More

Mov Disord Clin Pract 2021 Feb 29;8(2):193-207. Epub 2020 Dec 29.

Department of Neurological Sciences Rush University Medical Center Chicago Illinois USA.

Background: Movement disorders can be associated with or caused by hematological abnormalities. The objective of this review is to highlight features that will aid in the clinician's recognition and treatment of these disorders.

Methods: MESH terms relevant to movement disorders and hematologic diseases were searched to identify conditions included in this narrative, educational review. Read More

BMC Infect Dis 2021 Jan 28;21(1):121. Epub 2021 Jan 28.

Department of Hematology and Oncology, University Hospital, LMU Munich, Munich, Germany.

Background: Prolonged myelosuppression following CD19-directed CAR T-cell transfusion represents an important, yet underreported, adverse event. The resulting neutropenia and multifactorial immunosuppression can facilitate severe infectious complications.

Case Presentation: We describe the clinical course of a 59-year-old patient with relapsed/refractory DLBCL who received Axicabtagene-Ciloleucel (Axi-cel). Read More

Cleve Clin J Med 2020 11 2;87(11):649-650. Epub 2020 Nov 2.

James Graham Brown Cancer Center, University of Louisville School of Medicine, Louisville, KY.

Cureus 2020 Sep 21;12(9):e10568. Epub 2020 Sep 21.

Gastroenterology, All India Institute of Medical Sciences, Patna, IND.

Acute-on-chronic liver failure (ACLF) is characterized by acute decompensation of chronic liver disease associated with organ failures. Anemia of diverse etiology is common in patients with ACLF. Spur cell anemia (SCA) is a form of acquired hemolytic anemia that occurs rarely in such patients due to dysregulated lipids metabolism. Read More

J Microsc 2020 12 17;280(3):287-296. Epub 2020 Sep 17.

Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy.

In physiological conditions, red blood cells (RBCs) are capable of dramatic deformations when passing through the microvasculature. This extreme deformability is closely related to the RBC biconcave shape, to the fluidic nature of the haemoglobin and the cell membrane structure, primarily consisting of a phospholipid bilayer with an underlying two-dimensional spectrin network. In many pathological and inflammatory conditions, the shape and the extreme deformability of erythrocytes appear to be significantly altered. Read More

Clin J Gastroenterol 2020 Oct 29;13(5):882-890. Epub 2020 May 29.

Department of Gastroenterology, Gifu University Graduate School of Medicine, Gifu, Japan.

Spur cell anemia is an acquired hemolytic anemia associated with liver cirrhosis and is characterized by the presence of increased large red blood cells, which are covered with spike-like projections that vary in width, length, and distribution. A 26-year-old man was referred to our hospital presenting with jaundice, lower limb edema, and dyspnea. The patient was subsequently diagnosed with spur cell anemia related to alcoholic liver cirrhosis. Read More

J Biomed Opt 2020 01;25(1):1-13

City Univ. of Hong Kong, China.

Abnormally shaped red blood cells (RBCs), called poikilocytes, can cause anemia. At present, the biochemical abnormalities in poikilocytes are not well understood. Normal RBCs and poikilocytes were analyzed using whole-blood and single-cell methods. Read More

Rev Med Liege 2019 Oct;74(10):527-534

Service de Gastro-Entérologie et Hépatologie, CHU Liège, Belgique.

We report here the case of a 62-year-old patient with Child-Pugh stage C ethylic cirrhosis associated with severe macrocytic anaemia, refractory to iterative transfusions and withdrawal. After a haemorrhagic, deficiency-related, or sideroblastic etiology was ruled out, haemolytic anaemia was suspected. A blood smear allowed diagnosis of haemolytic anaemia with acanthocytes. Read More

Case Rep Hematol 2019 12;2019:3146965. Epub 2019 Feb 12.

Houston Methodist Hospital, Department of Medicine, 6550 Fannin St, Houston, TX 77030, USA.

Autosplenectomy (AS) is a known complication of diseases such as sickle cell anemia, celiac disease, and inflammatory bowel disease. We report the first known case of AS due to paroxysmal nocturnal hemoglobinuria (PNH). A 24-year-old Caucasian male had evidence of hemolytic anemia at the age of 14 and was diagnosed with PNH at the age of 16. Read More

N Engl J Med 2018 Aug;379(8):774

Oregon Health and Science University, Portland, OR

Case Rep Hematol 2018 21;2018:9513946. Epub 2018 Jun 21.

Department of Laboratory Medicine, Uji-Tokushukai Medical Center, Uji 611-0042, Japan.

Background: Spur cell anemia (SCA) is a cause of hemolytic anemia in patients with alcoholic liver cirrhosis. Because dyslipidemia is related to the development of spur cells, SCA was previously treated with plasmapheresis.

Case Report: A 52-year-old Japanese man with SCA associated with alcoholic liver cirrhosis (Child-Pugh C) underwent two rounds of plasmapheresis. Read More

BMJ Case Rep 2018 Jan 31;2018. Epub 2018 Jan 31.

Medical Oncology/Medicine, Captain James A. Lovell Federal Health Care Center, North Chicago, Illinois, USA.

Spur cell haemolytic anaemia (SCA) is a form of anaemia that can be seen in patients with severely impaired liver function or advanced cirrhosis. It is associated with high mortality. The treatment options for SCA secondary to cirrhosis are limited. Read More

Dig Dis Sci 2018 Jan 25;63(1):16-26. Epub 2017 Nov 25.

Department of Clinical and Experimental Medicine, Garibaldi Hospital, University of Catania, Via Palermo, 636, 95122, Catania, Italy.

Progressive lipoprotein impairment occurs in liver cirrhosis and is associated with increased morbidity and mortality. The present review aims to summarize the current evidence regarding the prognostic value of lipoprotein abnormalities in liver cirrhosis and to address the need of a better prognostic stratification of patients, including lipoprotein profile assessment. Low levels of lipoproteins are usual in cirrhosis. Read More

Blood 2017 12 6;130(25):2786-2798. Epub 2017 Nov 6.

Institute for Pathophysiology, West German Heart and Vascular Center and.

The hepatocyte nuclear factor (HNF) family regulates complex networks of metabolism and organ development. Human mutations in its prototypical member HNF1A cause maturity-onset diabetes of the young (MODY) type 3. In this study, we identified an important role for HNF1A in the preservation of erythrocyte membrane integrity, calcium homeostasis, and osmotic resistance through an as-yet unrecognized link of HNF1A to sphingolipid homeostasis. Read More

Clin Chim Acta 2017 May 20;468:81-84. Epub 2017 Feb 20.

Department of Hematology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India. Electronic address:

Introduction: Inherited anemias diagnostic workup requires a step-wise algorithm. Causal genes implicated in congenital hemolytic anemia are numerous, making a gene-by-gene approach by Sanger sequencing time consuming, expensive and labour intensive. Targeted resequencing can be of great use in explaining these cases. Read More

Med Clin North Am 2017 Mar 10;101(2):417-429. Epub 2016 Dec 10.

Division of Hematology/Medical Oncology, Department of Medicine, Oregon Health Sciences University, 3181 Southwest Sam Jackson Park Road, Portland, OR 97201-3098, USA; Division of Hematology/Medical Oncology, Department of Medicine, Knight Cancer Institute, Oregon Health and Science University, MC L586, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239, USA. Electronic address:

Many processes lead to anemia. This review covers anemias that are less commonly encountered in the United States. These anemias include hemoglobin defects like thalassemia, bone marrow failure syndromes like aplastic anemia and pure red cell aplasia, and hemolytic processes such as paroxysmal nocturnal hemoglobinuria. Read More

Int J Lab Hematol 2017 Jun 22;39(3):e64-e65. Epub 2016 Dec 22.

Department of Pediatrics, UCMS and GTB Hospital, New Delhi, India.

Gastroenterol Hepatol Bed Bench 2016 ;9(4):335-339

Department of Clinical and Experimental Medicine, Garibaldi Hospital, University of Catania, Italy.

Chronic anemia is common in liver cirrhosis. In this setting, the pathogenesis of anemia is complex and multifactorial. Spur cell anemia is a serious disorder in cirrhotic patients and is associated with poor prognosis. Read More

Transfusion 2016 Apr;56(4):787-8

University of Washington, Harborview Medical Center, Seattle, Washington.

Am J Hematol 2016 Oct 22;91(10):1061. Epub 2016 Mar 22.

Division of Hematology, Mayo Clinic, Rochester, Minnesota.

Rev Clin Esp 2016 May 5;216(4):233. Epub 2015 Dec 5.

Servicio de Hematología, Hospital Universitario de Móstoles, Móstoles, Madrid, España.

Nature 2015 Dec 9;528(7582):422-6. Epub 2015 Dec 9.

The Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario M5G 1X5, Canada.

DNA repair by homologous recombination is highly suppressed in G1 cells to ensure that mitotic recombination occurs solely between sister chromatids. Although many homologous recombination factors are cell-cycle regulated, the identity of the events that are both necessary and sufficient to suppress recombination in G1 cells is unknown. Here we report that the cell cycle controls the interaction of BRCA1 with PALB2-BRCA2 to constrain BRCA2 function to the S/G2 phases in human cells. Read More

J Med Case Rep 2014 Nov 27;8:390. Epub 2014 Nov 27.

Department of Clinical Medicine, Faculty of Medicine, University of Colombo, 25, Kynsey Road, Colombo 08, Sri Lanka.

Introduction: Klippel-Trenaunay syndrome is a rare congenital mesodermal abnormality characterized by bone and soft tissue hypertrophy, extensive hemangioma and venous abnormalities. We report the case of a patient with two additional rare clinical manifestations in the background of Klippel-Trenaunay syndrome, namely, acanthocytosis and splenic and retroperitoneal lymphangioma.

Case Presentation: A 24-year-old Sri Lankan man from North Central Province in Sri Lanka presented to our general medical unit with symptomatic anaemia. Read More

Clin Med Insights Pathol 2014 15;7:11-4. Epub 2014 Apr 15.

Institute of Environmental Health, China Medical University College of Public Health, Taichung, Taiwan.

Introduction: Unlike autoimmune hemolytic anemia (AIHA), literature on the etiological study of non-autoimmune hemolytic anemia (non-AIHA) is scarce. The incidence and prevalence of non-AIHA in different geographic regions are largely unknown perhaps owing to the lack of perspective investigation and different profiles of etiologies from different geographic regions. We aimed to examine the real-world etiology or mechanisms of the non-hereditary non-AIHA from a nationwide population-based administrative claim database in Taiwan. Read More

Zhonghua Yi Xue Za Zhi 2014 Mar;94(8):603-5

Department of Hematology, Affiliated Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China. Email:

Objective: To explore the clinical characteristic of adult hereditary spherocytosis (HS) and the efficacies of splenectomy.

Methods: Six cases with adult HS were collected from July 2006 to July 2012. And their clinical features, laboratory profile and treatment were retrospectively analyzed. Read More

Ann Hepatol 2014 May-Jun;13(3):396-8

Department of Medicine II, Saarland University Medical Center, Homburg, Germany.

Ann Indian Acad Neurol 2014 Jan;17(1):113-6

Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India.

Abetalipoproteinemia is an uncommon cause of ataxia and retinitis pigmentosa (RP). Most of the neurological and ocular manifestations occur secondary to deficiency syndromes that is consequent to fat malabsorption from the small intestine. In this report, we have described the phenotype of a young adult female who manifested with recurrent diarrheal illness in her first decade, followed by anemia, RP, and neurological involvement with progressive deafness, cerebellar and sensory ataxia, and subclinical neuropathy in her second decade of life. Read More

Am J Emerg Med 2014 Aug 25;32(8):944.e3-4. Epub 2014 Jan 25.

SUNY Upstate Medical University, Syracuse, NY 13210. Electronic address: