The case of a patient with cirrhosis of the liver suffering from severe haemolysis accompanied by circulating `spur cells' is described. Studies performed in an attempt to determine the cause for the abnormal shape of the erythrocytes demonstrated that the patient's serum could induce spur formation in normal compatible cells. Several lines of evidence pointed to the possibility that the factor inducing the spurs was a protein. By column chromatography and gradient ultracentrifugation it was shown that the patient's low density lipoproteins could induce spurs to form in normal cells.
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