Altered muscle metabolism shown by magnetic resonance spectroscopy in sickle cell disease with leg ulcers.
We performed 31P magnetic resonance spectroscopy of gastrocnemius muscle at rest in 7 normal volunteers and 12 patients with sickle cell disease (7 with leg ulcers and 5 without leg ulcers but with painful crises). We measured intracellular pH and ratios of Pi to ATP, PCr to ATP and PCr to Pi (Pi = inorganic phosphate, ATP = adenosine triphosphate, and PCr = phosphocreatine). Magnetic resonance arteriograms were also performed. Significant differences were found for PCr/Pi ratios between normals and sickle cell disease patients with leg ulcers (p < 0.008). Magnetic resonance arteriograms were normal in volunteers and patients with sickle cell disease. The altered high energy phosphate metabolism in sickle cell disease with leg ulcers is consistent with muscle ischemia or hypoxia.
Norris
S L
SL
Los Angeles County + USC Medical Center 90033.
Gober
J R
JR
Haywood
L J
LJ
Halls
J
J
Boswell
W
W
Colletti
P
P
Terk
M
M
D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications / Q000175:diagnosis / Q000378:metabolism*; D005069:Evaluation Studies as Topic; D005260:Female; D006450:Hemoglobin SC Disease / Q000150:complications / Q000175:diagnosis / Q000378:metabolism*; D006801:Humans; D007866:Leg / Q000098:blood supply / Q000473:pathology; D007871:Leg Ulcer / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism*; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods; D009682:Magnetic Resonance Spectroscopy / Q000295:instrumentation / Q000379:methods; D008297:Male; D009132:Muscles / Q000378:metabolism* / Q000473:pathology