Successful combination therapy - Flunarizine, pentoxifylline, and cholestyramine - for spur cell anemia

Citation
K. Aihara et al., Successful combination therapy - Flunarizine, pentoxifylline, and cholestyramine - for spur cell anemia, INT J HEMAT, 73(3), 2001, pp. 351-355
Citations number
19
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Hematology
Journal title
INTERNATIONAL JOURNAL OF HEMATOLOGY
ISSN journal
0925-5710 → ACNP
Volume
73
Issue
3
Year of publication
2001
Pages
351 - 355
Database
ISI
SICI code
0925-5710(200104)73:3<351:SCT-FP>2.0.ZU;2-C
Abstract
Spur cell anemia, a hemolytic anemia observed in patients with alcoholic ci rrhosis, is characterized by unusual erythrocyte morphology and an increase d ratio of free cholesterol to phospholipid in the erythrocyte membrane. Th e prognosis of spur cell anemia is usually extremely poor, however, we desc ribe here a patient with spur cell anemia who was successfully treated with combination therapy consisting of flunarizine, pentoxifylline. and cholest yramine. Initial therapy with flunarizine alone for 6 weeks did not signifi cantly decrease the number of spur cells on peripheral blood smears. So pen toxifylline was added to the regimen. The patient recovered from the anemia , showed remarkable improvement with regard to the hyperbilirubinemia. and the changes were accompanied by a significant decrease in the number of spu r cells in peripheral blood smears. To correct the hypercholesterolemia. ch olestyramine was added to the regimen, which resulted in a reduction in the serum level of free cholesterol and an increase in the molar ratio of free cholesterol to phospholipid in erythrocyte membrane. However, 6 months lat er a skin eruption developed that was considered an adverse reaction to the drugs, so the flunarizine and pentoxifylline were discontinued. With chole styramine therapy alone, the remission of spur cell anemia was maintained f or more than 11 months. These observations suggest that non-invasive combin ation therapy with flunarizine, pentoxifylline, and cholestyramine is effec tive and valuable in the treatment of patients with spur cell anemia. (C) 2 001 The Japanese Society of Hematology.