Peripheral Ischaemia Caused by Blood Hyperviscosity<sup>1</sup>

McGrath, Michael A.; Tracy, G. D.; Lord, Reginald S. A.; Penny, Ronald

doi:10.1111/j.1445-2197.1973.tb07320.x

Cited by 13 publications

(4 citation statements)

References 8 publications

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“…In addition, the hand blood flows in 15 normal adult subjects (laboratory and hospital staff) were measured. Within this group there was no significant relationship between hand blood flow and age, thus supporting conclusions reached previously (Shepherd, 1963 , 1976;1977a, b;McGrath et al, 1973) but referred to herein as considered relevant and to emphasize the significance and specificity of the observations in scleroderma.…”

Section: Hand Blood Flowsupporting

confidence: 91%

Blood hyperviscosity with reduced skin blood flow in scleroderma

McGrath¹,

Peek²,

Penny³

1977

Annals of the Rheumatic Diseases

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SUMMARY The vascular complications of scleroderma have previously been attributed to the progressive obliteration of small vessels. Our study was carried out to determine whether abnormalities of blood viscosity occur in this disease, thereby contributing to th-ischaemic process. Blood viscosity was measured in 20 patients using a rotational viscometer. At a high rate of shear, blood hyperviscosity was found in 35 % of the patients and at a low rate of shear, in 70 %. In addition there was a significant increase in the plasma viscosity which implicates changes in plasma proteins (fibrinogen, immunoglobulins) as causing the hyperviscosity. Measurement of the hand blood flow by venous occlusion plethysmography showed reduced flow at 320, 270, and 20°C. A unique finding was a delayed recovery of the blood flow after cooling. These observations suggest that the increased resistance to blood flow in skin affected by scleroderma may be caused by an interaction between the occlusive vascular lesion and blood hyperviscosity. In addition, blood flow patterns and hyperviscosity could help distinguish scleroderma from primary Raynaud's disease.In patients with scleroderma several of the clinical features, such as Raynaud's phenomenon, can be attributed to a reduced blood flow through small arteries, arterioles, and capillaries. Histological and radiological studies have confirmed the existence of vascular abnormalities in this disease (Soila, 1964;Norton and Nardo, 1970;Rodnan, 1972;Campbell and LeRoy;1975), although the cause of these changes is unknown. Since the resistance to blood flow is partly dependent on the blood viscosity, detailed studies were carried out to determine whether blood hyperviscosity exists in patients with scleroderma, thereby contributing to the already increased vascular resistance associated with narrowing of the vessel lumen. The degree of impairment of the skin blood flow in this group of patients was assessed by measuring hand blood flow and its response to cooling. We compared the results with those obtained in patients with other connective tissue diseases and with impaired peripheral circulation. PatientsTwenty patients with scleroderma were studied.

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Section: Hand Blood Flowsupporting

confidence: 91%

Blood hyperviscosity with reduced skin blood flow in scleroderma

McGrath¹,

Peek²,

Penny³

1977

Annals of the Rheumatic Diseases

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“…This diagnosis becomes more likely if there is accompanying phlebitis. An increase in blood viscosity, as occurs in polycythemia or paraproteinemia, can present with digital ischemia despite normal pulses [8]. In patients with coexisting atherosclerosis, claudication tends to be improved by treatment of hyperviscosity.…”

Section: Discussionmentioning

confidence: 99%

The natural history of chronic leg ischemia

et al. 1983

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The onset of leg ischemia may be sudden or gradual, occurring over a wide age spectrum and as a result of multiple causes. The clinical outcome is extremely variable, and only about 1 patient in 8 will progress to the stage of ischemic gangrene. Many patients have the capacity to show marked clinical improvement, or to maintain a comfortable life with claudication that is not severely disabling. Of over 2,000 patients referred to a vascular unit, only about 30% required operative intervention. Rigorous conservative measures should be given a trial for at least 3 months in all patients except those whose limbs are severely threatened, since that period of time is necessary to judge the capacity for spontaneous improvement, before the patient is subjected to the invasive technique of aortography. A flow chart of management decisions is suggested for patients with intermittent claudication.

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“…El síndrome de hiperviscosidad puede presentarse hasta en el 40% de los casos de macroglobulinemia de Waldeström (IgM) y 10% en mieloma múltiple tipo IgA, por lo cual la proliferación monoclonal de estas dos inmunoglobulinas tiende a manifestarse más comúnmente como dedo azul 11 . Clínicamente se debe sospechar cuando encontramos livedo reticularis, acrocianosis e isquemia digital, asociados a otros cambios sugestivos de neoplasias plasmáticas 61 .…”

Section: • Paraproteinemiasunclassified

Síndrome del dedo azul: de la piel a lo multisistémico

Cross¹,

Guerra²,

Restrepo³

et al. 2022

Rev. Argent. Reumatol.

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El signo del dedo azul (SDA) es una condición poco frecuente causada principalmente por la oclusión de la vasculatura periférica. Clínicamente puede manifestarse como una coloración azulada o eritrocianótica en uno o varios dedos en ausencia de traumatismo y condiciones propias de congelación. Las etiologías son múltiples e incluyen obstrucción del flujo arterial, disminución del flujo venoso y alteración en la viscosidad sanguínea. La importancia de reconocer el signo como motivo de consulta radica en encaminar un diagnóstico temprano e instaurar un tratamiento que evite la evolución natural de la enfermedad hacia la necrosis, amputación o muerte del paciente. Proponemos un algoritmo diagnóstico para reconocer los elementos de la historia clínica que guíen la etiología y los paraclínicos disponibles desde el Servicio de Urgencias.

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Peripheral Ischaemia Caused by Blood Hyperviscosity¹

Cited by 13 publications

References 8 publications

Blood hyperviscosity with reduced skin blood flow in scleroderma

Blood hyperviscosity with reduced skin blood flow in scleroderma

The natural history of chronic leg ischemia

Síndrome del dedo azul: de la piel a lo multisistémico

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Peripheral Ischaemia Caused by Blood Hyperviscosity1

Cited by 13 publications

References 8 publications

Blood hyperviscosity with reduced skin blood flow in scleroderma

Blood hyperviscosity with reduced skin blood flow in scleroderma

The natural history of chronic leg ischemia

Síndrome del dedo azul: de la piel a lo multisistémico

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Peripheral Ischaemia Caused by Blood Hyperviscosity¹