Cutaneous microvascular blood flow and reactivity in patients with homozygous sickle cell anaemia

:  Homozygous sickle cell anaemia (SS disease) involves a high prevalence of skin ulcerations, and background experience concerning the cutaneous microcirculatory flux and reactivity in this disease is very limited. We investigated, by laser‐Doppler velocimetry, the microcirculatory cutaneous blood...

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Bibliographic Details
Published in:European journal of haematology 2002-06, Vol.68 (6), p.327-331
Main Authors: Tharaux, Pierre Louis, Girot, Robert, Kanfer, Alain, Dussaule, Jean Claude, Gaitz, Jean Pierre, Tribout, Laurent, Baudot, Nathalie, Vayssairat, Michel
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Anemia, Sickle Cell - genetics
Anemia, Sickle Cell - physiopathology
Anemias. Hemoglobinopathies
Biological and medical sciences
Diseases of red blood cells
Female
Hematologic and hematopoietic diseases
Homozygote
Humans
hyperaemia
Laser-Doppler Flowmetry
laser-Doppler velocimetry
Male
Medical sciences
microcirculation
Microcirculation - physiopathology
Regional Blood Flow
sickle cell disease
Skin - blood supply
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Summary::  Homozygous sickle cell anaemia (SS disease) involves a high prevalence of skin ulcerations, and background experience concerning the cutaneous microcirculatory flux and reactivity in this disease is very limited. We investigated, by laser‐Doppler velocimetry, the microcirculatory cutaneous blood flow and vasoreactivity in 17 patients with SS disease but no cutaneous trophic changes, vs. the corresponding values in 18 normal matched controls. The laser‐Doppler probe was placed on the foot dorsum, and recordings were made in the supine and dependent positions, and after post‐ischaemic hyperaemia. The venoarteriolar reflex was calculated as the difference between the fluxes in the supine and dependent positions. In both positions, patients with SS disease exhibited clear vasodilation, with larger cutaneous fluxes than those of the controls (P=0.024 and 0.0009, respectively). The venoarteriolar reflex, expressed as a percentage of the resting supine flux, was lower in the patients (P=0.0004). These impairments of the microcirculatory fluxes, which combine a vasodilated state with abnormal vasoreactivity, resemble those observed in patients with chronic venous insufficiency and might be crucial in determining the pathogenesis of the skin ulcerations that occur in SS disease. Laser‐Doppler velocimetry seems a suitable non‐invasive technique for investigating such cutaneous microangiopathy.
ISSN:0902-4441
1600-0609
DOI:10.1034/j.1600-0609.2002.02701.x