To the editor: Radiographic contrast media have been reported to cause morphologic "sickling" in vitro of erythrocytes containing hemoglobin S (1). However, complications from angiography in patients with sickle cell disease have been rare (2). The clinical relevance and the significance of the in-vitro observations are unclear (3), but nevertheless, it is recommended that patients with sickle cell anemia be given transfusions before angiography to lower the hemoglobin S level to an arbitrarily set value (4). Whether these recommendations should be applied to patients with hemoglobin S-C disease is not clear.

Before 1983, eight angiographic procedures had been done in...


  • 1. PERILLIEEPSTEIN PF. Sickling phenomenon produced by hypertonic solutions: a possible explanation for the hyposthenuria of sicklemia. J Clin Invest. 1963;42:570-80. CrossrefMedlineGoogle Scholar
  • 2. RICHARDSNULSEN DF. Angiographic media and the sickling phenomenon. Surg Forum. 1971;22:403-4. MedlineGoogle Scholar
  • 3. MURPHYWENGARDBRERETON JMW. Rheological studies of Hb SS blood: influence of hematocrit, hypertonicity, separation of cells, deoxygenation, and mixture with normal cells. J Lab Clin Med. 1976;87:475-86 MedlineGoogle Scholar
  • 4. STOCKMANNIGROMISHKINOSKI JMMF. Occlusion of large cerebral vessels in sickle-cell anemia. N Engl J Med. 1972;287:846-9. CrossrefMedlineGoogle Scholar
  • 5. RAOLEE KM. Risks associated with angiography in patients with sickle cell disease. Radiology. 1983;147:600-1. MedlineGoogle Scholar

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