Spectrum of anemia associated with chronic liver disease

Table 1 Management of acute gastrointestinal bleeding

Treatment of variceal bleeding
Pharmacological therapy
Somatostatin: initial bolus (24-48 h) and a perfusion (5 d)
Octreotide: initial bolus (24-48 h) and a perfusion (5 d)
Terlipressin: important side effects
Primary prophylaxis
β-blockers non-selective: propranolol, nadolol
Isosorbide 5-mononitrate
Secondary prophylaxis
β-blockers non-selective: propranolol, nadolol
Isosorbide 5-mononitrate
Endoscopy therapy: band ligation, sclerotherapy

Table 2 Etiologic factors that may contribute to anemia associated with alcoholism (adapted from Lewis et al[26])

Cause of low hematocrit	Possible contributing factors
Hemorrhage and/or iron deficiency	Alcoholic gastritis
	Portal hypertension
	Peptic ulceration
Hemolysis	Chronic liver disease and/or cirrhosis
	Zieve syndrome
	Spur cell anemia of severe liver disease
Reduced erythropoiesis	Anemia of chronic disease
	Nutritional (e.g. folic acid deficiency)
	Sideroblastic anemia
	Alcohol toxicity
Hypersplenism	Portal hypertension
Hemodilution	Fluid retention of chronic liver disease
	Aggressive intravenous fluid therapy

Source: Nat Clin Pract Gastroenterol Hepatol© 2007 Nature Publishing Group.