title: [Hemolytic anemia secondary to the placement of a portosystemic stented shunt].
abstract: BACKGROUND
  portal hypertension and variceal hemorrhage are common complications of hepatic cirrhosis, both associated with a high morbimortality. Portal system decompression by the placement of a transjugular intrahepatic portosystemic stented shunt, can reduce portal venus pressure and is effective controling complications of portal hypertension, like variceal hemorrhage and ascitis. The aim of this document is to describe a case of hemolytic anemia secondary to the placement of a transjugular intrahepatic portosystemic stented shunt.
  
  
  METHODS
  patient with portal hypertension secondary to liver cirrosis was given a transjugular intrahepatic portosystemic stented shunt for recurrent variceal hemorrhage. After the procedure, hemoglobin decreased 2 g/dL, associated with reticulocitosis, hipohaptoglobinemia, elevated lactic dehydrogenase and indirect hyperbilirrubinemia with negative Coombs test. The peripheral blood smear showed abnormal erythrocytes, with the prevalence of schistocytes. The final diagnosis was hemolytic anemia secondary to transjugular intrahepatic portosystemic stented shunt.
  
  
  CONCLUSIONS
  the hemolytic anemia secondary to Transjugular Intrahepatic Portosystemic Stented Shunt is a rare complication. Usually, it has a benign prognosis, and it is self-limited once the stent is endothelialized.
authors.affiliation: Unidad de Terapia Intensiva. Fundación Clínica Médica Sur, Tlalpan, D.F., México. revistacma95@yahoo.com.mx
authors.forename: Raúl
authors.initials: R
authors.lastname: Carrillo-Esper
authors.forename: Ulises
authors.initials: U
authors.lastname: Carrillo-Cortes
authors.forename: Jorge Raúl
authors.initials: JR
authors.lastname: Carrillo-Córdova
authors.forename: Luis Daniel
authors.initials: LD
authors.lastname: Carrillo-Córdova
authors.forename: Carlos Alberto
authors.initials: CA
authors.lastname: Carrillo-Córdova
authors.forename: Dulce María
authors.initials: DM
authors.lastname: Carrillo-Córdova
mesh_terms: D000328:Adult; D000743:Anemia, Hemolytic / Q000097:blood / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D001772:Blood Cell Count; D017707:Erythrocyte Transfusion; D004932:Esophageal and Gastric Varices / Q000209:etiology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006242:Haptoglobins / Q000032:analysis; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D006932:Hyperbilirubinemia / Q000209:etiology; D006975:Hypertension, Portal / Q000601:surgery*; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008103:Liver Cirrhosis / Q000150:complications; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000009:adverse effects* / Q000295:instrumentation; D012156:Reticulocytes; D015607:Stents
chemical_list: D006242:Haptoglobins; D006454:Hemoglobins; D007770:L-Lactate Dehydrogenase
keywords: crenocite; hemolytic anemia; portal hypertension; transjugular intrahepatic portosystemic stent shunt