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Haemolysis and abnormal haemorheology in sickle cell anaemia.
[alpha-thalassemia]
Although
pulmonary
hypertension
,
leg
ulcers
,
priapism
,
stroke
and
glomerulopathy
in
sickle
cell
anaemia
(
SCA
)
result
from
the
adverse
effects
of
chronic
haemolysis
on
vascular
function
(
haemolytic
phenotype
)
,
osteonecrosis
,
acute
chest
syndrome
and
painful
vaso-occlusive
crises
are
caused
by
abnormal
vascular
cell
adhesion
and
increased
blood
viscosity
(
viscosity-vaso-occlusion
phenotype
)
.
However
,
this
model
with
two
sub-phenotypes
does
not
take
into
account
the
haemorheological
dimension
.
We
tested
the
relationships
between
the
biological
parameters
reflecting
the
haemolytic
rate
(
haemolytic
component
)
and
red
blood
cell
(
RBC
)
rheological
characteristics
in
97
adults
with
SCA
.
No
significant
difference
in
the
proportion
of
patients
with
low
or
high
haemolytic
component
in
the
low
and
high
blood
viscosity
groups
was
observed
.
The
RBC
elongation
index
(
i
.
e
.
deformability
)
was
negatively
correlated
with
the
haemolytic
component
.
The
RBC
aggregates
strength
(
i
.
e
.
RBC
aggregates
robustness
)
was
negatively
correlated
with
RBC
elongation
index
.
Sickle
RBCs
with
high
density
had
lower
elongation
index
and
higher
aggregates
strength
.
In
conclusion
,
(
i
)
the
'
haemolytic
'
phenotype
is
characterized
by
decreased
RBC
deformability
and
increased
RBC
aggregates
strength
and
(
ii
)
the
viscosity-vaso-occlusive
phenotype
is
characterized
by
increased
RBC
deformability
but
not
always
by
increased
blood
viscosity
.
α-thalassaemia
modulates
the
haemorheological
properties
but
other
factors
seem
to
be
involved
.
Diseases
Validation
Diseases presenting
"priapism"
symptom
alpha-thalassemia
This symptom has already been validated