Chronic leg ulceration is a major cause of morbidity in homozygous sickle cell (SS) disease in Jamaica. These ulcers have features in common with venous ulcers in patients with a normal haemoglobin genotype (AA). Thus we sought to determine whether there is abnormal venous function in the legs of patients with SS disease who have ulcers. Experiments were performed on 15 SS patients with ulcers, and on 15 SS patients and 15 AA subjects with no history of leg ulcers. Changes in venous blood volume of the bottom one-third of the leg induced by venous occlusion and release were studied by air plethysmography, providing indices of segmental venous capacitance (SVC), maximal venous outflow (MVO) and venous emptying time (VET). The changes in volume (ambulatory volume change; AVC) induced by a period of leg exercise were also measured at the ankle (AVCa) and calf (AVCc); venous refilling times at these sites (RTa and RTc respectively) were also measured. Finally, cutaneous red blood cell flux recovery time (FRT) after ankle exercise was assessed by laser Doppler flowmetry. Measurements were also made of haematological variables. SVC, MVO and VET did not differ between the groups, indicating no deep venous obstruction in the SS patients with ulcers. AVCc, AVCa and RTc did not differ among the three subject groups. However, compared with AA subjects, SS patients with ulcers had reduced RTa and FRT. Moreover, RTa and FRT were further shortened in SS patients with ulcers relative to SS patients without ulcers. Since the levels of anaemia were similar in SS patients with and without ulcers, these differences cannot be attributed to differences in arterial flow secondary to anaemia. These results suggest abnormal venous function in SS patients with ulcers, relative to both AA subjects and SS patients without ulcers. We propose that there is incompetence of venous valves draining the ankle region of SS patients with ulcers: the consequent raised venous pressure contributes to the slow healing and, possibly, to the onset of leg ulceration in SS disease.
Skip Nav Destination
Article navigation
Research Article|
May 08 2000
Abnormal venous function in patients with homozygous sickle cell (SS) disease and chronic leg ulcers
Junette S. MOHAN;
Junette S. MOHAN
*Department of Basic Medical Sciences (Physiology Section), Faculty of Medical Sciences, University of West Indies, Kingston, Jamaica
Search for other works by this author on:
Jacqueline E. VIGILANCE;
Jacqueline E. VIGILANCE
*Department of Basic Medical Sciences (Physiology Section), Faculty of Medical Sciences, University of West Indies, Kingston, Jamaica
Search for other works by this author on:
Janice M. MARSHALL;
†Department of Physiology, The Medical School, Birmingham B15 2TT, U.K.
Correspondence: Professor J. M. Marshall (e-mail [email protected]).
Search for other works by this author on:
Ian R. HAMBLETON;
Ian R. HAMBLETON
‡Medical Research Council Laboratories (Jamaica), University of West Indies, Kingston, Jamaica
Search for other works by this author on:
Harvey L. REID;
Harvey L. REID
*Department of Basic Medical Sciences (Physiology Section), Faculty of Medical Sciences, University of West Indies, Kingston, Jamaica
Search for other works by this author on:
Graham R. SERJEANT
Graham R. SERJEANT
‡Medical Research Council Laboratories (Jamaica), University of West Indies, Kingston, Jamaica
Search for other works by this author on:
Publisher: Portland Press Ltd
Received:
January 04 2000
Accepted:
January 27 2000
Online ISSN: 1470-8736
Print ISSN: 0143-5221
The Biochemical Society and the Medical Research Society © 2000
2000
Clin Sci (Lond) (2000) 98 (6): 667–672.
Article history
Received:
January 04 2000
Accepted:
January 27 2000
Citation
Junette S. MOHAN, Jacqueline E. VIGILANCE, Janice M. MARSHALL, Ian R. HAMBLETON, Harvey L. REID, Graham R. SERJEANT; Abnormal venous function in patients with homozygous sickle cell (SS) disease and chronic leg ulcers. Clin Sci (Lond) 1 June 2000; 98 (6): 667–672. doi: https://doi.org/10.1042/cs0980667
Download citation file:
Sign in
Don't already have an account? Register
Sign in to your personal account
You could not be signed in. Please check your email address / username and password and try again.
Could not validate captcha. Please try again.
Biochemical Society Member Sign in
Sign InSign in via your Institution
Sign in via your InstitutionGet Access To This Article
Cited By
Open Access for all
We offer compliant routes for all authors from 2025. With library support, there will be no author nor reader charges in 5 journals. Check here |
![]() |