MORPHOLOGICAL PATTERNS OF ANEMIA AND TREATMENT APPROACHES IN PATIENTS WITH LIVER CIRRHOSIS ADMITTED TO A TERTIARY CARE MEDICAL UNIT

Abstract

Anemia is a common complication associated with liver cirrhosis; however, it is also a complication that is often underestimated. Several factors contribute to this issue, including malnutrition, chronic inflammatory processes, hypersplenism, and reduced activity of bone marrow. It is crucial to appreciate the variety of patterns of morphological manifestations of anemia present in this cohort of patients to ensure it is diagnosed in a timely manner, and to make sure the appropriate management can be instituted.

Methodology: This descriptive cross-sectional study was conducted in the Medical Unit of Gomal Medical College, Dera Ismail Khan, from January 2024 to January 2025. 72 adults with documented liver cirrhosis were included through consecutive sampling. Demographic data, clinical data, complete blood counts, and data from peripheral smears were collected. Anemia was classified as normocytic, microcytic, macrocytic, or dimorphic according to red cell indices and smear variables. Therapeutic measures administered during the patients' hospital stays were also documented.

Results: Normocytic anemia emerged as the most common morphological type, followed by microcytic and macrocytic patterns, while dimorphic anemia was observed in a smaller proportion. Associations between anemia patterns and selected laboratory parameters showed significant variation, with lower hemoglobin and albumin levels more frequently seen in patients with microcytic and dimorphic anemia. These findings highlight the multifactorial nature of anemia in cirrhosis and its relationship with disease severity.

Conclusion: The findings of the research are such that among cirrhotic patients, normocytic anemia is of primary concern, although the microcytic and macrocytic patterns also play a considerable role. These patterns serve a purpose in guiding the clinician toward nutritional deficit recognition, occult blood loss, or bone marrow suppression, in a timely manner for more directives to be managed. Assessing the anemia pattern in cirrhosis is of great importance in aiding the medical professional in improving the clinical decision, more so, the overall patient's condition.