A 12-year-old patient with liver cirrhosis shows which type of abnormal red blood cells in a peripheral blood smear?

In the context of liver cirrhosis, spur cells, also known as acanthocytes, are a type of red blood cell that can be observed in a peripheral blood smear. These cells acquire a spiky or irregular shape due to alterations in the lipid composition of the red blood cell membrane, which is often related to the liver's impaired ability to metabolize lipids effectively.

In liver disease, particularly cirrhosis, there is often an increase in cholesterol and decreased phospholipid levels, leading to this abnormal morphology. The presence of spur cells can be indicative of severe liver dysfunction, which aligns with the patient's diagnosis of cirrhosis.

While burr cells, target cells, and dacrocytes also have specific associations with various conditions, they are not characteristically found in patients with liver cirrhosis. Burr cells, for instance, are often seen in cases of uremia or renal disease. Target cells can be representative of conditions like hemoglobinopathies or liver disease, but the definitive association with cirrhosis is much stronger for spur cells. Dacrocytes, or teardrop cells, are typically seen in myelofibrosis or conditions leading to extramedullary hematopoies