Poster Presenter

Pentoxifylline - A Novel Treatment For Spur Cell Haemolytic Anaemia Complicating Alcoholic Cirrhosis
Dr M.A. Butt, Dr D.I. Ismail, Dr L.T.H. Pee, Dr A. Owolabi, Dr A.J.K. Piotrowicz
UK

Spur cell haemolytic anaemia is a rare complication of alcoholic cirrhosis and generally carries a poor prognosis. The only definitive cure reported in the literature is liver transplant. In the United Kingdom, patients with severe alcoholic cirrhosis have to be abstinent from alcohol for at least 6 months prior to consideration of liver transplantation.

We report on the successful use of pentoxifylline in a 43-year-old man who presented with decompensated alcoholic cirrhosis with alcoholic hepatitis and spur cell haemolytic anaemia. Initial treatment with steroids controlled the hepatitis but not the haemolytic anaemia. The addition of pentoxifylline successfully treated the haemolysis for 3 ½ months judged by a significant reduction in transfusion requirements. Unfortunately, he rapidly deteriorated and died from sepsis with multi-organ failure following this period.

Only one other study in the literature has used pentoxifylline for this condition but in combination with flunarizine and cholestyramine. We report the first use of pentoxifylline as the sole pharmacological agent to treat this rare haemolytic complication and highlight its potential to act as a bridge to liver transplantation in patients not initially meeting liver transplant criteria.