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Figure 1. Scanning electron microscopy (x5000) reveals numerous acanthocytes diagnostic of spur-cell anemia in a peripheral-blood specimen from a jaundiced 43-year-old woman with alcoholic cirrhosis and anemia. Several putative factors, including an altered ratio of cholesterol to phospholipid in the erythrocyte membrane, stagnation of sterols on the red-cell membrane, retention of bile acids, and changes in plasma lecithin-cholesterol acyltransferase concentrations, may be involved in the pathogenesis of spur cells.
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