Preliminary Studies of Sludged Blood in Multiple Sclerosis

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Abstract
The blood in the bulbar conjunctival vessels of 24 selected multiple sclerosis patients was examined for sludge at magnification of 31x and 47x. The patients were studied on 2 occasions, separated by an interval of 10-12 mos. In the 1st series of 19 patients, 13 showed sludge to a significant degree. In the 2d series of 18 patients, sludge was observed in all instances. In 9 of the 13 patients in both series there was an increase in the amt. of sludge in the interval of 10-12 mos. separating the observations. These observations suggest that sludged blood might be considered as one pathogenetic factor underlying especially the fleeting symptoms or the insidious relapses so commonly observed in the course of multiple sclerosis. Thrombus-like formations caused by sludge were observed in the vessels in 2 of the multiple sclerosis patients. It is postulated that the thrombosis of blood vessels in multiple sclerosis which has been observed by some investigators may be due to lumps of sludge in the blood which are caught in the small blood vessels and which might interfere with or block the blood flow, as in the 2 instances observed in the present studies. Laboratory examinations paralleling the observations on sludge reveal the following: increase in leukocytes in 5 cases, increase in sedimentation rates in 9 cases, and high cholesterol levels in 4 cases. These changes, however, were mostly temporary. Fatty acid detns., glucose tolerance tests, and prothrombin levels did not disclose significant or lasting abnormal changes. However, the fact that some of the patients did show leukocytosis, higher cholesterol levels, and higher sedimentation rates, is evidence that further studies are indicated.