Manrai M, Dawra S, Kapoor R, Srivastava S, Singh A. Anemia in cirrhosis: An underestimated entity. World J Clin Cases 2022; 10(3): 777-789 [PMID: 35127894 DOI: 10.12998/wjcc.v10.i3.777]
Reader's ID:
05841184
Submitted on:
January 27, 2022, 20:47
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Reader Comments:
I read with great interest the minireview about anemia related to chronic liver disease. From clinical point of view, this is a very interesting topic, a real everyday problem in the management of cirrhotic patients. From academic point of view, the problem is well known, but still there are not too many research article dealing with this matter. I thing that this is a solid review that highlights the most important entities, mechanisms, related conditions and treatment options. It also stresses the significant value of anemia as a prognostic indicator in cirrhotic patients.
I have only two small remarks. In the contrary to chronic bleeding, and according to most relevant classification, acute blood loss manifests with normocytic anemia. In this article acute and chronic blood loss were related to microcytic anemia. These two conditions stimulate different compensatory mechanisms and reflect differently on the complete blood count. Hence, in my opinion, these two entities should be discussed separately.
Also, considering the multifactorial etiopathogenesis of anemia related to chronic liver disease and the difficult diagnostic process we are constantly facing, I expected that this review article would have reported some data regarding the place and role of bone marrow examination in the diagnostic process. This is an invasive procedure that is not often performed, but sometimes, in severe, complex cases, this procedure is an inevitable diagnostic tool which provides the definitive diagnosis and also a possibility for curative treatment.
In general, I think that this is very nice and informative review about anemia related to chronic liver disease, a complex, multifactorial and challenging entity.
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First, thank you very much for your professional comments on the article published in World Journal of Clinical Cases.
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Author's Reply:
Replied on January 26, 2024, 14:50
Sir, we accept your suggestions and will strive to work on them in our next related publication