Scanning electron microscopic studies on morphological abnormalities of erythrocytes in alcoholic liver diseases

Background: We previously reported that morphological abnormalities and the altered deformability of erythrocytes play important roles in disturbances of hepatic microcirculation associated with alcoholic liver disease. Methods: The subjects of this study were five patients with alcoholic liver cirrhosis, two patients with alcoholic fatty liver, and two healthy volunt eers. Concentrating on erythrocyte morphology in the presence of alcoholic liver disease, we observed erythrocytes under a scanning electron microscop e and examined their morphological changes in relation to the disease. Results: Among the five patients with alcoholic liver cirrhosis, stomatocyt es accounted for about 14% and acanthocytes for about 10% of all erythrocyt es. In the fatty liver group (n = 2), acanthocytes were absent, and stomato cytes accounted for 23% in one subject and 56% in the other, of the total. When the two patients with liver cirrhosis were examined over time, one of them was found to have 12% stomatocytes, 21% acanthocytes, and a filtration time of 14.7 sec at admission. Following 1 month of abstinence, this patie nt had 1% stomatocytes, 6% acanthocytes, and a filtration time of 10.4 sec, which were accompanied by improvements in peripheral blood parameters and liver function. In another patient with liver cirrhosis, there were no acan thocytes, 8% stomatocytes, and a filtration time of 5 sec at admission; thi s patient had 1% stomatocytes and a filtration time of 7.7 sec after 1 mont h of abstinence. In one patient with fatty liver who was examined over time , the percentage of stomatocytes was 56%, and the filtration time was 7.7 s ec at admission; these parameters were 1% and 5.1 sec, respectively, after 1 month of abstinence. Conclusions: The present study revealed that stomatocytes and acanthocytes are morphologically abnormal erythrocytes observed in the presence of alcoh olic liver disease. These abnormal forms of erythrocytes tended to normaliz e as peripheral blood parameters and liver function were improved by abstin ence, which suggests that erythrocyte morphology is related to the pathophy siology of alcoholic liver disease.