[Diagnosis of anemia in alcoholic cirrhosis]

Anemia in patients with alcoholic liver cirrhosis is a common issue. The diagnosis could be difficult because of the multiplicity of causes, usually associated, and specificities in the diagnostic approach. This subject has not been reviewed for almost two decades. We propose a review based upon analysis of the literature and our clinical experience.

Because of the alcoholism and the biological consequences of the liver disease, laboratory findings, especially the mean corpuscular volume, should be interpreted with caution in the diagnostic approach. Despite these drawbacks, the diagnosis of anemia is detailed according to the usual plan: normocytic, macrocytic and microcytic anemias. Finally, we propose practical guidelines.

Further prospective studies should assess the real burden of nutritional deficiencies, easily treatable. The prognostic significance of hemolytic anemias in patients with alcoholic liver cirrhosis should be studied.