Hematocrit

Red Cell

Erythrocyte aggregation

Blood viscosity

Microcirculation

Surgery

Cardiology

Anemia

Red blood cell

Immunology

Sickle cell anemia

Hemorheology

Pathophysiology

Internal medicine

Priapism

Hemolysis

Medicine

Disease

Pathology

Clinical Hemorheology and Microcirculation

This review focuses on the contribution of abnormal blood rheology in the pathophysiology of sickle cell anemia (SCA). SCA is characterized by a reduction of red blood cell (RBC) deformability but this reduction is very heterogeneous among patients. Recent works have shown that patients with the lowest RBC deformability (measured by ektacytometry) have enhanced hemolysis and would be more prone to develop several complications such as priapism, leg ulcers and glomerulopathy. In contrast, patients with the highest deformability, and not under hydroxyurea therapy, seem to develop more frequently vaso-occlusive like events. Although less studied, RBC aggregation properties are very different between SCA and healthy individuals and it was demonstrated that increased RBC aggregates strength could be involved in some complications. Finally, several studies have established that the vascular system of SCA patients could not fully compensate any increase in blood viscosity because of the loss of vascular reactivity, which may result in vaso-occlusive crises.

Blood rheological abnormalities in sickle cell anemia