Download PDF
Thromb Haemost 2006; 96(04): 483-487
DOI: 10.1160/TH06-05-0254
Blood Coagulation, Fibrinolysis and Cellular Haemostasis
Schattauer GmbH

Increased red blood cell aggregation in patients with idiopathic intracranial hypertension

A hitherto unexplored pathophysiological pathway
Anat Kesler
1   Departments of Ophthalmology, Tel Aviv Sourasky Medical Center affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
,
Yossi Yatziv
1   Departments of Ophthalmology, Tel Aviv Sourasky Medical Center affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
,
Itzhak Shapira
2   Departments of Medicine D and Tel Aviv Sourasky Medical Center affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
,
Shlomo Berliner
2   Departments of Medicine D and Tel Aviv Sourasky Medical Center affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
,
Einor Ben Assayag
3   Departments of Neurology, Tel Aviv Sourasky Medical Center affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
› Author Affiliations
Further Information

Publication History

Received 09 May 2006

Accepted after resubmission 16 August 2006

Publication Date:
29 November 2017 (online)

    Permissions and Reprints

Summary

It was the objective of this study to explore the possibility that the aggregation of red blood cells is enhanced in individuals with increased intracranial hypertension (IIH). This is a prospective cross sectional examination in a cohort of patients with IIH and matched controls.The aggregation of red blood cells in the peripheral venous blood was determined by using a slide test and image analysis.We have presently included a group of 33 women with IIH and the same number of women matched for age, body mass index, vascular risk factors and medications. A significant (p=0.038) increment in fibrinogen concentrations was noted in the patients (341 ± 60.8 mg/dl) as opposed to the controls 307.9 ± 64.8).The same stands for the aggregation of red blood cells (aggregation parameter of 8.7 ± 4.9 in patients vs.5.9 ± 3.2 in the controls, p=0.001).We noted an increment in the aggregation of red blood cells in the peripheral blood of 33 women with IIH as opposed to matched controls. Being associated with capillary slow flow,these findings might be relevant to the ethiopathogenesis of this disease.

Keywords

Idiopathic intracranial hypertension - pseudo tumor cerebri - aggregation
 

  • References

  • 1 Soutani M, Suzuki Y, Tateishi N. et al. Quantitative evaluation of flow dynamics of erythrocytes in microvessels: influence of erythrocyte aggregation. Am J Physiol 1995; 268: H1959-H1965.
    PubMedGoogle Scholar
  • 2 Schmid-Schonbein H. Blood rheology and physiology of microcirculation. Ric Clin Lab 1981; 11 (Suppl. 01) 13-33.
    PubMedGoogle Scholar
  • 3 Bishop JJ, Nance PR, Popel AS. et al. Effect of erythrocyte aggregation on velocity profiles in venules. Am J Physiol Heart Circ Physiol 2001; 280: H222-H236.
    CrossrefPubMedGoogle Scholar
  • 4 Mchedlishvili G, Gobejishvili L, Mamaladze A. et al. Microcirculatory stasis induced by hemorheological disorders: further evidence. Microcirculation 1999; 06: 97-106.
    CrossrefPubMedGoogle Scholar
  • 5 Cabel M, Meiselman HJ, Popel AS. et al. Contribution of red blood cell aggregation to venous vascular resistance in skeletal muscle. Am J Physiol 1997; 272: H1020-H1032.
    PubMedGoogle Scholar
  • 6 Mchedlishvili G, Varazashvili M, Gobejishvili L. Local RBC aggregation disturbing blood fluidity and causing stasis in microvessels. Clin Hemorheol Microcirc 2002; 26: 99-106.
    PubMedGoogle Scholar
  • 7 Bishop JJ, Nance PR, Popel AS. et al. Relationship between erythrocyte aggregate size and flow rate in skeletal muscle venules. Am J Physiol Heart Circ Physiol 2004; 286: H113-H120.
    CrossrefPubMedGoogle Scholar
  • 8 Yalcin O, Uyuklu M, Armstrong JK. et al. Graded alterations of RBC aggregation influence in vivo blood flow resistance. Am J Physiol Heart Circ Physiol 2004; 287: H2644-H2650.
    CrossrefPubMedGoogle Scholar
  • 9 Kim S, Popel AS, Intaglietta M. et al. Aggregate formation of erythrocytes in postcapillary venules. Am J Physiol Heart Circ Physiol 2005; 288: H584-H590.
    CrossrefPubMedGoogle Scholar
  • 10 Radhakrishnan K, Ahlskog JE, Garrity JA. et al. Idiopathic intracranial hypertension. Mayo Clin Proc 1994; 69: 169-80.
    CrossrefPubMedGoogle Scholar
  • 11 Rogowski O, Vered Y, Shapira I. et al. Introducing the wide range C-reactive protein (wr-CRP) into clinical use for the detection of microinflammation. Clin Chim Acta 2005; 358: 151-8.
    CrossrefPubMedGoogle Scholar
  • 12 Berliner S, Rogowski O, Aharonov S. et al. Erythrocyte adhesiveness/aggregation. A novel biomarker for the detection of low grade internal inflammation in individuals with atherothrombotic risk factors and proven. vascular disease. Am HeartJ 2005; 149: 260-7.
    CrossrefPubMedGoogle Scholar
  • 13 Rogowski O, Toker S, Shapira I. et al. Values of high sensitivity C-reactive protein in each month of the year in apparently healthy individuals. Am J Cardiol 2005; 95: 152-5.
    CrossrefPubMedGoogle Scholar
  • 14 Zeltser D, Rogowski O, Mardi T. et al. Clinical and laboratory characteristics of patients with atherothrombotic risk factors presenting with low concentrations of highly sensitive C-reactive protein. Atherosclerosis 2004; 176: 297-301.
    CrossrefPubMedGoogle Scholar
  • 15 Zeltser D, Rogowski O, Berliner S. et al. Sex differences in the expression of haemorheological determinants in individuals with atherothrombotic risk factors and apparently health people. Heart 2004; 90: 277-81.
    CrossrefPubMedGoogle Scholar
  • 16 International committee for standardization in hematology. Recommendation of measurement of erythrocyte sedimentation rate of human blood. Immunochemistry 1965; 02: 235-54.
    CrossrefPubMedGoogle Scholar
  • 17 Clauss A. Gerinnungsphysiologische Schnellmethode zur Bestimmung des Fibrinogens. Acta Haematol Basel 1957; 17: 237-46.
    CrossrefPubMedGoogle Scholar
  • 18 Schechner V, Shapira I, Berliner S. et al. Significant dominance of fibrinogen over immunoglobulins, C-reactive protein, cholesterol and triglycerides in maintaining increased red blood cell adhesiveness/aggregation: a model in hypercholaesterolemic patients. Eur J Clin Invest 2003; 33: 955-61.
    CrossrefPubMedGoogle Scholar
  • 19 Gamzu R, Rotstein R, Fusman R. et al. Increased erythrocyte adhesiveness and aggregation in peripheral venous blood of women with pregnancy-induced hypertension. Obstet Gynecol 2001; 98: 307-12.
    PubMedGoogle Scholar
  • 20 Samocha-Bonet D, Lichtenberg D, Tomer A. et al. Enhanced erythrocyte adhesiveness/aggregation in obesity corresponds to low-grade inflammation. Obes Res 2003; 11: 403-7.
    CrossrefPubMedGoogle Scholar
  • 21 Fusman G, Mardi T, Justo D. et al. Red blood cell adhesiveness/aggregation, C-reactive protein, fibrinogen and erythrocyte sedimentation rate in healthy adults and in those with atherosclerotic risk factors. Am J Cardiol 2002; 90: 561-3.
    CrossrefPubMedGoogle Scholar
  • 22 Berliner S, Shapira I, Rogowski O. et al. Combined leukocyte and erythrocyte aggregation in the peripheral venous blood during sepsis.A clue to the presence of a commonly shared adhesive protein(s). Int J Clin Lab Res 2000; 30: 27-31.
    CrossrefPubMedGoogle Scholar
  • 23 Rotstein R, Fusman R, Zeltser D. et al. The picture of inflammation: a new concept that combines the white blood cell count and erythrocyte sedimentation rate into a new hematologic diagnostic modality. Acta Haematol 2001; 106: 106-14.
    CrossrefPubMedGoogle Scholar
  • 24 Sharshun Y, Brill S, Mardi T. et al. Inflammation at a glance: erythrocyte adhesiveness/aggregation to reveal the presence of inflammation in individuals with atherothrombosis. Heart Dis 2003; 05: 182-3.
    CrossrefPubMedGoogle Scholar
  • 25 Owler BK, Parker G, Halmagyi GM. et al. Pseudotumor cerebri syndrome: venous sinus obstruction and its treatment with stent placement. J Neurosurg 2003; 98: 1045-55.
    CrossrefPubMedGoogle Scholar
  • 26 Glueck CJ, Iyengar S, Goldenberg N. et al. Idiopathic intracranial hypertension: associations with coagulation disorders and polycystic-ovary syndrome. J Lab Clin Med 2003; 142: 35-45.
    CrossrefPubMedGoogle Scholar
  • 27 Rotstein R, Landau T, Twig A. et al. The erythrocyte adhesiveness/aggregation test (EAAT). A new biomarker to reveal the low grade subclinical smoldering inflammation in individuals with atherosclerotic risk factors. Atherosclerosis 2002; 165: 343-51.
    CrossrefPubMedGoogle Scholar
  • 28 Maharshak N, Shapira I, Rotstein R. et al. The erythrocyte adhesiveness/aggregation test for the detection of an acute phase response and for the assessment of its intensity. Clin Lab Haematol 2002; 24: 205-10.
    CrossrefPubMedGoogle Scholar
  • 29 Ben Assayag E, Bornstein NM, Shapira I. et al. Inflammation sensitive proteins and erythrocyte aggregation in atherothrombosis. Int J Cardiol 2005; 98: 271-6.
    CrossrefPubMedGoogle Scholar
  • 30 Berliner S, Ben-Ami R, Samocha-Bonet D. et al. The degree of red blood cell aggregation on peripheral blood glass slides corresponds to inter-erythrocyte cohesive forces in laminar flow. Thromb Res 2004; 114: 37-44.
    CrossrefPubMedGoogle Scholar
  • 31 Zeltser D, Rotstein R, Rogowski O. et al. The erythrocyte adhesiveness/aggregation (EAAT) in the peripheral blood of patients with ischemic heart and brain disease with normal fibrinogen concentrations. Appl Rheol 2000; 10: 231-7.
    PubMedGoogle Scholar
  • 32 Zeltser D, Bornstein NM, Rotstein R. et al. The erythrocyte adhesiveness/aggregation test in the peripheral blood of patients with ischemic brain events. Acta Neurol Scand 2001; 103: 316-9.
    CrossrefPubMedGoogle Scholar
  • 33 Marckmann P. Nutritional status of patients on hemodialysis and peritoneal dialysis. Clin Nephrol 1988; 29: 75-8.
    PubMedGoogle Scholar
  • 34 Hankey CR, Rumley A, Lowe GD. et al. Moderate weight reduction improves red cell aggregation and factor VII activity in overweight subjects. Int J Obes Relat Metab Disord 1997; 21: 644-50.
    CrossrefPubMedGoogle Scholar
  • 35 Ditschuneit HH, Flechtner-Mors M, Adler G. Fibrinogen in obesity before and after weight reduction. Obes Res 1995; 03: 43-8.
    CrossrefPubMedGoogle Scholar
  • 36 Banyai S, Banyai M, Falger J. et al. Atorvastatin improves blood rheology in patients with familial hypercholesterolemia (FH) on long term LDL apheresis treatment. Atherosclerosis 2001; 159: 513-9.
    CrossrefPubMedGoogle Scholar
  • 37 Sugerman HJ, Felton III WL, Sismanis A. et al. Gastric surgery for pseudotumor cerebri associated with severe obesity. Ann Surg 1999; 229: 634-40.
    CrossrefPubMedGoogle Scholar
  • 38 Sugerman HJ, Felton III WL, Salvant Jr JB. et al. Effects of surgically induced weight loss on idiopathic intracranial hypertension in morbid obesity. Neurology 1995; 45: 1655-9.
    CrossrefPubMedGoogle Scholar
  • 39 Gabay C, Kushner I. Mechanisms of disease: acutephase proteins and other systemic responses to inflammation. N Engl J Med 1999; 340: 448-54.
    CrossrefPubMedGoogle Scholar