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August 1985

Red Cell Fragmentation Syndrome With the Use of Subclavian Hemodialysis Catheters

Author Affiliations

From the Department of Medicine, Loyola University Stritch School of Medicine, Maywood, Ill (Drs Nand, Bansal, Kozeny, Vertuno, and Remlinger), and the Clinical Hematology Branch, National Institute of Arthritis, Diabetes, and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Md (Dr Jordan).

Arch Intern Med. 1985;145(8):1421-1423. doi:10.1001/archinte.1985.00360080095013

• The red cell fragmentation syndrome can occur due to abnormalities of the heart or the blood vessels or vascular malformations. We describe three patients who developed symptomatic hemolytic anemia due to red cell fragmentation with the use of single-lumen subclavian hemodialysis catheters. Retrospective analysis of 75 other patients who had undergone dialysis through this catheter disclosed five additional cases. Red cell fragmentation appears to be associated with partial catheter occlusion by thrombus or development of a clot at the catheter tip or both. The fragmentation resolved in all cases on withdrawal of the catheter. All patients with this catheter should be closely monitored for the red cell fragmentation syndrome, and the catheter should be withdrawn if it develops. White cell fragmentation was also seen in one patient.

(Arch Intern Med 1985;145:1421-1423)