Which condition is characterized by Acanthocytes on a blood smear?

Acanthocytes, which are abnormally shaped red blood cells with irregular projections, are most commonly associated with liver disease. Their presence in a blood smear indicates an alteration in the lipid composition of the cell membrane, which often occurs in conditions affecting the liver. Specifically, in liver disease, especially conditions like severe liver dysfunction or cholestasis, the metabolism of lipoproteins is altered, leading to the formation of acanthocytes.

The relevance of this finding extends to conditions such as abetalipoproteinemia, which is linked with liver disease and characterized specifically by the presence of acanthocytes. Other options present conditions that do not typically result in this specific type of red blood cell morphology. Chronic kidney disease may lead to anemia but does not characteristically cause acanthocyte formation. Similarly, lead poisoning primarily affects the nervous system and produces basophilic stippling rather than acanthocytes, while celiac disease typically does not lead to this specific change in red blood cells. The identification of acanthocytes is an important diagnostic clue in evaluating liver health and function.