The Diagnosis Is in the Smear: A Case and Review of Spur Cell Anemia in Cirrhosis

Table 3

Hemolysis panel during hospitalization.

	Day 2	Pre-steroids (Day 6)	Pre-IVIG (Day 13)	Post-IVIG (Day 15)
Hgb	7.4	9.0	7.4	7.0
Haptoglobin	<10	<10	<10	<10
Indirect bili	9.2	8	11.4	17.3
LDH	263	393	285	292

Patient was initiated on steroids on Day 6 at 1 mg/kg for three days, increased to 1.5 mg/kg for five days (day 8 through 13) with no clinical response, and was subsequently placed on a taper which was continued until her death.