Microangiopathic Haemolytic Anaemia: Mechanisms of Red‐Cell Fragmentation: <i>in Vitro</i> Studies

Summary. Several of the disease states in which red‐cell fragments appear in the peripheral blood have features suggestive of intravascular coagulation with fibrin deposition in vessels. As this process might be a cause of red‐cell fragmentation the interaction of rapidly moving red cells with fibrin strands was investigated.Red cells arrested on fibrin strands while moving through a loose fibrin clot at the velocity of arterial blood flow were bent over the strands by the force of blood flow and eventually fragmented. The shape of the fragments which resulted depended upon the position and plane in which the red cells were arrested, the point at which the membrane ruptured, the distribution of haemoglobin and membrane between the resulting fragments and finally on whether or not crenation of the fragments supervened.Systems in which red cells perfused artificial ‘clots’ of glass fibre and nylon also caused the red cells to fragment. The fragmentation process seems to depend, therefore, on a rapid blood flow and the arrest of individual red cells by any obstruction of small dimensions, e. g. by strands or spikes less than I p in diameter. It was concluded that these conditions were most likely to obtain in vivo as the result of intravascular deposits of fibrin in the lumen of small arterioles.

Microangiopathic Haemolytic Anaemia: Mechanisms of Red‐Cell Fragmentation: in Vitro Studies Journal Articles