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Plasmapheresis in Raynaud's phenomenon in systemic sclerosis: a microcirculatory study
M J Jacobs1, P J Jörning, E J Van Rhede van der Kloot
1Department of Surgery, University Hospital Maastricht, The Netherlands.
International Journal of Microcirculation, Clinical and Experimental
|February 1, 1991
Summary
Plasmapheresis improved symptoms and healed skin ulcers in patients with Raynaud's phenomenon by enhancing red blood cell velocity and reducing plasma viscosity. While symptoms returned in most, improved blood flow persisted, suggesting plasmapheresis benefits for digital ischemia.
Area of Science:
- Rheology
- Vascular Biology
- Dermatology
Background:
- Secondary Raynaud's phenomenon in systemic sclerosis causes microcirculatory disturbances.
- Haemorheological changes, including red blood cell aggregation and plasma viscosity, contribute to diminished skin blood flow.
Purpose of the Study:
- To investigate the effects of plasmapheresis on microcirculatory and haemorheological parameters in patients with secondary Raynaud's phenomenon.
- To assess the long-term efficacy of plasmapheresis in managing symptoms and improving blood flow.
Main Methods:
- Eighteen patients with secondary Raynaud's phenomenon underwent 4 weekly plasmapheresis treatments.
- Microcirculatory and haemorheological parameters (RBC velocity, aggregation, plasma viscosity) were measured before and after treatment.
- Patient-reported outcomes, including symptom improvement and ulcer healing, were recorded.
Main Results:
- Plasmapheresis led to significant improvements in Raynaud's phenomenon, cold provocation response, and skin ulcer healing.
- Red blood cell velocity increased significantly, while RBC aggregation and plasma viscosity decreased significantly post-treatment.
- Symptom recurrence was observed in 14 patients after 6-9 months, but skin ulcers did not return. Enhanced skin capillary blood flow persisted for 24 months.
Conclusions:
- Plasmapheresis effectively improves microcirculation and haemorheology in secondary Raynaud's phenomenon.
- Disturbed haemorheology plays a key role in the reduced skin blood flow characteristic of this condition.
- Plasmapheresis is a viable treatment option for severe digital ischemia in patients with secondary Raynaud's phenomenon.