Clinical potential of in vitro measured red cell deformability, a myth?

For many years the study of Red Blood Cell (RBC) deformability has been lim ited to specialised hematological research institutes and this has hampered a widespread clinical testing of this dynamic RBC property. Consequently, the clinical relevance of such in vitro measurements has remained questiona ble now for a considerable time. The recent availability of the LORCA, a ro utinely applicable and computer assisted instrument for this purpose, opens now the possibility to evaluate RBC deformability on a large scale in vari ous pathological situations associated with impaired microcirculatory flow. In this communication we present our clinical experience obtained thusfar w ith this instrument. Besides the effect of physiological aging of normal RB C, the results of a clinical study on malaria tropica, case studies of here ditary elliptocytosis, Smith-Lemli-Opitz syndrome (a cholesterol biosynthes is defect), the treatment of sickle cell crisis with hydroxy-urea as well a s the clinical intervention with Cyclosporin, are collected. In conclusion, it can be stated that the limited clinical experience with t he LORCA as is reported here, yields sufficient evidence about the clinical potential of this technique.