Premium
Cutaneous microvascular blood flow and reactivity in patients with homozygous sickle cell anaemia
Author(s) -
Tharaux Pierre Louis,
Girot Robert,
Kanfer Alain,
Dussaule Jean Claude,
Gaitz Jean Pierre,
Tribout Laurent,
Baudot Nathalie,
Vayssairat Michel
Publication year - 2002
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1034/j.1600-0609.2002.02701.x
Subject(s) - laser doppler velocimetry , hyperaemia , medicine , supine position , microangiopathy , blood flow , reflex , sickle cell anemia , cardiology , vascular disease , microcirculation , pathology , disease , endocrinology , diabetes mellitus
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.