Serial Changes in Coagulation and Viscosity during Sickle‐Cell Crisis

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Abstract
Summary. Coagulation activity and whole‐blood viscosity were measured in the steady state, and serially during painful crisis, in eight patients with sickle‐cell anaemia. Platelet and coagulation activation occurred in the steady state and became more pronounced early in crisis. Whole‐blood viscosity increased during crisis in parallel with plasma fibrinogen. Similar changes were found in a parallel study of 20 patients with localized bacterial or viral infection who did not have sickle‐cell anaemia. Reports of platelet activation, hypercoagulability, and hyperviscosity during painful crisis therefore reflect secondary changes arising from vascular stasis, precipitating infection, and an acute‐phase protein reaction. Although secondary, these changes may contribute to vascular occlusion by an additive effect in vessels already partially occluded by sickled cells.