Post-splenetomy spur cell hemolytic anemia

A patient with post-necrotic cirrhosis is described in whom spur cell hemolytic anemia developed eight years after splenectomy in association with worsening liver function. The presence of a spleen or splenic function is therefore not essential either for the formation of spur cells or for the hemolysis of such cells. Splenectomy therefore should be regarded with circumspection in the management of patients with spur cell hemolytic anemia.