Reversibility of echinocyte formation after contact of erythrocytes with various radiographic contrast media

Abstract

Various radiographic contrast media (RCM) significantly influence the morphology of erythrocytes, especially the formation of echinocytes [Scand. J. Clin. Lab. Invest. 35 (1975), 1–43; Microvasc. Res. 60 (2000), 193–200; Herz 23 (2003), 35–41]. Microscopic studies, however, have shown that these changes of erythrocyte morphology are possibly reversible [Acta Radiol. 37 (1996), 214–217]. The aim of this study was to proof if the RCM-induced echinocyte formation can be reversed by a resuspension in autologous plasma. In this study four RCMs were tested (Iodixanol, Iohexol, Iomeprol and Iopromide). These RCM induced echinocyte formation (after suspension of erythrocytes in plasma/RCM mixtures for 10 min at 37°C), which was reversible after resuspension in autologous RCM-free plasma (resuspension time 5 min at 37°C). Especially for Iomeprol and Iopromide – the RCMs which induced the strongest echinocyte formation – an echinocyte reduction from 94.2% to 44.5% and for Iopromide from 80.6% to 50.4% occurred. The echinocyte formation was influenced by the type of RCM as well as by the RCM concentration. The same was true for the reversibility of echinocyte formation due to resuspension in autologous plasma (type of RCM: p≤0.0001; concentration of RCM: p=0.0847). Iodixanol was associated with the least numbers echinocytes formed (after suspension in the plasma/RCM-mixture as well as after the resuspension in autologous plasma). A 100% reversibility back to discocytes was observed in none of the RCMs after resuspension in autologous RCM-free plasma.