This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Diane C. Salyer, MD; William R. Salyer, MD
Baltimore

Arch Intern Med. 1974;134(1):181.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—The section concerning sickle cell disease in the review of prostaglandins in hematology¹ deserves additional comment.

The most common renal abnormality in patients with sickle cell disease is a concentrating defect, associated in many older patients with focal renal papillary necrosis and scarring.

The pathogenesis of these functional and anatomic abnormalities is unknown. Perillie and Epstein² have argued that the hypertonicity present in the renal medulla may lead to erythrocyte sickling in the vasa recta that is independent of oxygen tension, with resultant increased blood viscosity, decreased medullary blood flow, and decreased oxygen delivery to the renal tubular cells. The morphologic studies of Statius van Eps et al³ are consistent with reduced medullary blood flow.

An alternative hypothesis is suggested by data recently presented by Johnson et al⁴ and Rabinowitz et al.⁵ They observed sickling associated with a marked decrease in oxygen . . . [Full Text PDF of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?