I am not sure but i will try to explain :sorry:Why do you get anemia in liver failure? Also why do you have increased estrogens in liver failure? thanks
17 keto steroids are also metabolised by liver...in liver failure these steroids r converted to estrogen by peripheral aromatisation...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.
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.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