Morphology of Red Blood Cells in Patients with Liver Cirrhosis at the University of Calabar Teaching Hospital, South South Nigeria

This study examines the morphological characteristics of red blood cells (RBCs) in patients with liver cirrhosis attending the gastroenterology unit at the University of Calabar Teaching Hospital (UCTH), Cross River State, South South Nigeria. Liver disease produces characteristic RBC morphological abnormalities reflecting dyserythropoiesis, altered lipid metabolism, and portal hypertension-related haematological changes. A cross-sectional study recruited 80 liver cirrhosis patients classified by Child-Pugh score and 40 healthy controls. Peripheral blood films were prepared from fresh EDTA-anticoagulated blood and examined under oil immersion for RBC morphology, including the presence of target cells, acanthocytes, stomatocytes, elliptocytes, and macrocytes. Full blood count parameters were simultaneously assessed. Results revealed target cells in 67.5 percent of cirrhotic patients, stomatocytes in 32.5 percent, and macrocytosis in 41.3 percent. Anaemia was present in 76.3 percent of cirrhosis patients, worsening with Child-Pugh grade. Acanthocytosis was exclusively observed in Child-Pugh C patients with severe hepatic dysfunction. The degree of morphological abnormality correlated significantly with Child-Pugh score and serum bilirubin levels. These findings reinforce the value of peripheral blood film examination as a complementary diagnostic and monitoring tool in liver cirrhosis management and support a recommendation for routine morphological assessment alongside standard liver function tests at UCTH. Keywords: liver cirrhosis, red blood cell morphology, target cells, anaemia, Cross River State.