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Why do you get anemia in liver failure? Also why do you have increased estrogens in liver failure? thanks
I am not sure but i will try to explain :sorry:

You get anemia in liver failure due to anemia of chronic disease.

And as estrogen is metabolized in the liver so you get increased estrogen in liver failure.
 
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I am not sure but i will try to explain :sorry:

You get anemia in liver failure due to anemia of chronic disease.

And as estrogen is metabolized in the liver so you get increased estrogen in liver failure.
17 keto steroids are also metabolised by liver...in liver failure these steroids r converted to estrogen by peripheral aromatisation...
 

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one of the functions of liver is to catabolise hormones... in liver failure insulin, glucagon, glucocortecoid, growth hormones, estrogen, prathyroid all are increased....

anemia... apart of anemia of chronic disease, derangement of PT, aPTT and portal hypertension causes bleeding, which may cause anemia as well... i just thought this anemia thing... correct me if i m wrong at this point!!!
 

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Just an addition !!!
liver also produces erythropoietin, in adults although it's only 10% as compared to 90% produced by the kidney.
So, relative deficiency of erythropoietin can also contribute to anemia in liver failure.

Source; google. Can't remember the exact link
 
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however the main reason of anemia in liver failure is HYPERSPLENISM... hepatic failure is accompanied by portal hypertension which has 4 components 1 ascites 2 hypersplenism 3 collateral varices 4 splenomegaly.... hypersplenism in this causes thrombocytopenia and anemia!!!
 

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Answer: There are two main causes (1) Liver disease may cause megaloblastic anemia. Remember absorbed vitamine B12 from the gut forms B12+transcobalamin II complex in the blood ? The transcobalamin II is a serum B12 transporter produced by your liver. So liver disease reduces the transcobalamin II production and subsequently impairs B12 delivery to your bone marrow for making erythrocytes. (2) liver cirrhosis can also cause anemia via hyperactive reticuloendothelial system (namely hypersplenism as stated by "DoctorF") (3) I have to point out that the reason "step1an" stated for anemia is NOT entirely the case. Because liver's role in producing EPO is not significant enough to influence hemostasis if you have healthy bone marrows. Only when your bone marrow becomes aplastic such as in Meylodysplastic syndrome, your liver then starts taking over the role of producing significant amount of EPO (this is called extramedullary hematopoiesis) http://www.usmle-forums.com/members/step1an.html----- So anemia secondary to liver disease can be either megaloblastic type or normocytic type, or mixture of both.
 

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anemia of liver disease

Pathophysiology of Anemia in patients with liver disease depends on the etiology. However I believe the following theory plays a major common rule in all causes: " Absorption of Iron from the gut is mediated by transepithelial transporter called (Ferroportin), Ferroportin is inhibited by (Hepacidin), Hepacidin is the major regulator of iron absorption from the gut. So if the level of stored iron in the body is increased, hepacidin level will increase to inhibit further absorption & vice verca. Hepacidin is also an acute phase reactant, so the level of hepacidin will be high for prolonged period in any chronic inflammatory disease that will inhibit absorption of iron for a prolonged period of time causing what's known as "Anemia of Chronic disease".

type of anemia in liver diseases depends on the etiology :

1) Cirrhosis: due to abnormal cholestrol production, red cells are changed in shape and are hemolyzed.

2) portal hypertension: causes splenic sequestaration & cytopenia

3) alcohol abuse : is associated with nutritional anemias (folate, b12 ... )

4) viral hepatitis: can cause anema through directly inhibiting the bone marrow & through autoimmune hemolysis of RBC

5) GI blood loss (esophageal varices rupture & bleeding)

*** any different combinations between these factor is possibly the cause of anemia in patients with liver disease
 

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Pathophysiology of Anemia in patients with liver disease depends on the etiology. However I believe the following theory plays a major common rule in all causes: " Absorption of Iron from the gut is mediated by transepithelial transporter called (Ferroportin), Ferroportin is inhibited by (Hepacidin), Hepacidin is the major regulator of iron absorption from the gut. So if the level of stored iron in the body is increased, hepacidin level will increase to inhibit further absorption & vice verca. Hepacidin is also an acute phase reactant, so the level of hepacidin will be high for prolonged period in any chronic inflammatory disease that will inhibit absorption of iron for a prolonged period of time causing what's known as "Anemia of Chronic disease".

type of anemia in liver diseases depends on the etiology :

1) Cirrhosis: due to abnormal cholestrol production, red cells are changed in shape and are hemolyzed.

2) portal hypertension: causes splenic sequestaration & cytopenia

3) alcohol abuse : is associated with nutritional anemias (folate, b12 ... )

4) viral hepatitis: can cause anema through directly inhibiting the bone marrow & through autoimmune hemolysis of RBC

5) GI blood loss (esophageal varices rupture & bleeding)

*** any different combinations between these factor is possibly the cause of anemia in patients with liver disease
I don't think this is correct. Liver failure causes a macrocytic non-megaloblastic anemia. Hepcidin increase would cause a microcytic anemia. Also, I don't see how hepcidin is supposed to be increased if you are in liver failure, it would be the opposite.

None of the other things would cause that type of anemia either.
 
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