Essential thrombocythemia, hemolytic anemia and hepatic cirrhosis: Could there be an association?

Vascular events are the most common clinical complication of essential thrombocythemia, leading to sign and symptoms of this disease. There are various sign and symptoms of essential thrombocythemia, such as thrombosis in artery or vein, and enlarged spleen. Portal hypertension and hepatic cirrhosis could be caused by essential thrombocythemia via intrahepatic thrombus. Anemia in essential thrombocythemia patient treated with hydroxyurea could be the side effect of bone marrow supression and also hydroxyurea induced hemolytic anemia. Association betweeen autoimmune hemolytic anemia and primary biliary cirrhosis or hepatic cirrhosis has been discussed. This case report presented an patient diagnosed with essential thrombocythemia. He later developed hepatic cirrhosis possibly caused by intra hepatic thrombus in the setting of hypercoagulabuility in myeloproliverative disorders. He also sufferred from anemia due to hydroxyurea induced hemolytic anemia. Association between autoimmune hepatic cirrhosis and autoimmune hemolytic anemia should also be considered in this patient.

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Living Donor Liver Transplantion for Primary Biliary Cirrhosis with Autoimmune Hemolytic Anemia: A Case Report

Digestive Diseases and Sciences ◽

10.1007/s10620-006-9396-6 ◽

2007 ◽

Vol 52 (11) ◽

pp. 3237-3239 ◽

Cited By ~ 4

Author(s):

Masaki Kaibori ◽

Yoichiro Uchida ◽

Morihiko Ishizaki ◽

Takamichi Saito ◽

Junko Hirohara ◽

...

Keyword(s):

Case Report ◽

Primary Biliary Cirrhosis ◽

Hemolytic Anemia ◽

Autoimmune Hemolytic Anemia ◽

Living Donor ◽

Biliary Cirrhosis ◽

Donor Liver

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Pulmonary hypertension associated with primary biliary cirrhosis in the absence of portal hypertension: a case report.

Gut ◽

10.1136/gut.35.2.280 ◽

1994 ◽

Vol 35 (2) ◽

pp. 280-282 ◽

Cited By ~ 15

Author(s):

E M Yoshida ◽

S R Erb ◽

D N Ostrow ◽

D R Ricci ◽

C H Scudamore ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Case Report ◽

Portal Hypertension ◽

Primary Biliary Cirrhosis ◽

Biliary Cirrhosis

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Primary biliary cirrhosis and cold autoimmune hemolytic anemia: Effect of partial plasma exchange

Gastroenterology ◽

10.1016/0016-5085(80)90874-4 ◽

1980 ◽

Vol 78 (3) ◽

pp. 576-578 ◽

Cited By ~ 12

Author(s):

Jerome B. Orlin ◽

Eugene M. Berkman ◽

Daniel S. Matloff ◽

Marshall M. Kaplan

Keyword(s):

Primary Biliary Cirrhosis ◽

Plasma Exchange ◽

Hemolytic Anemia ◽

Autoimmune Hemolytic Anemia ◽

Biliary Cirrhosis

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Primary Biliary Cirrhosis and Hemolytic Anemia Confusing Serum Bilirubin Levels

Canadian Journal of Gastroenterology ◽

10.1155/2000/148063 ◽

2000 ◽

Vol 14 (5) ◽

pp. 445-447 ◽

Cited By ~ 5

Author(s):

M Brackstone ◽

Cameron N Ghent

Keyword(s):

Liver Transplantation ◽

Chronic Disease ◽

Primary Biliary Cirrhosis ◽

Hemolytic Anemia ◽

Autoimmune Hemolytic Anemia ◽

Serum Bilirubin ◽

Hereditary Spherocytosis ◽

Biliary Cirrhosis

Hemolysis is observed in more than 50% of patients with cirrhosis. However, there has been little documention of the association of primary biliary cirrhosis with autoimmune hemolytic anemia. Two cases, found within a single practice, of primary biliary cirrhosis coexisting with autoimmune hemolysis and a third case coexisting with hereditary spherocytosis are presented. Anemia in such patients is commonly attributed to chronic disease, and hyperbilirubinemia is attributed to primary biliary cirrhosis. These patients were considered for liver transplantation until the diagnosis of a comorbid hemolytic process was established. This association may be more prevalent than previously recognized. A diagnosis of comorbid hemolysis must always be considered in context with anemia and serum bilirubin levels that rise out of proportion to the severity of the primary biliary cirrhosis.

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