Digital ischemia and gangrene due to red blood cell aggregation induced by acquired dysfibrinogenemia

H. C. Kwaan*, M. Levin, S. Sakurai, O. Kucuk, M. W. Rooney, L. J. Lis, J. W. Kauffman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Digital gangrene was observed in a patient who had angiographic findings of digital arterial occlusion. The patient's blood showed a marked red blood cell aggregation with rouleaux formation in long chains, which could not be dispersed at shear rates up to 200 sec-1. Studies of the patient's blood revealed the presence of an abnormal fibrinogen capable of aggregating normal red blood cells. This fibrinogen was found by Raman spectroscopy to have an increased α-helical content, whereas the β-sheet content was decreased. Defibrinogenation therapy with ancrod resulted in a dramatic symptomatic relief. The disappearance of the abnormal fibrinogen 6 months later and an absence of a family history indicate that this dysfibrinogenemia was acquired.

Original languageEnglish (US)
Pages (from-to)1061-1068
Number of pages8
JournalJournal of Vascular Surgery
Volume26
Issue number6
DOIs
StatePublished - 1997

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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