“Acanthocytogenesis” — Or How the Red Cell Won Its Spurs

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Abstract
A decade ago, Smith, Lonergan and Sterling noted that peculiarly shaped erythrocytes could be found in patients with hemolysis associated with severe liver disease.1 Although these poikilocytes were morphologically indistinguishable from the "acanthocytes" found in a-beta-lipoproteinemia, they were easily distinguished chemically by an absolute increase in membrane-free cholesterol. Subsequent studies by Cooper and others have convincingly demonstrated that the increase in membrane cholesterol is an acquired property secondary to some abnormality in the plasma of patients with liver disease. Moreover, at least early in the process, the change was found to be reversible when such cholesterol-enriched cells were incubated in . . .