Abstract
BackgroundAsthma and sickle cell disease are common conditions that both may result in pulmonary complications. We hypothesized that children with sickle cell disease with concomitant asthma have an increased incidence of vaso-occlusive crises that are complicated by episodes of acute chest syndrome.MethodsA 5-year retrospective chart analysis was performed investigating 48 children ages 3–18 years with asthma and sickle cell disease and 48 children with sickle cell disease alone. Children were matched for age, gender, and type of sickle cell defect. Hospital admissions were recorded for acute chest syndrome, cerebral vascular accident, vaso-occlusive pain crises, and blood transfusions (total, exchange and chronic). Mann-Whitney test and Chi square analysis were used to assess differences between the groups.ResultsChildren with sickle cell disease and asthma had significantly more episodes of acute chest syndrome (p = 0.03) and cerebral vascular accidents (p = 0.05) compared to children with sickle cell disease without asthma. As expected, these children received more total blood transfusions (p = 0.01) and chronic transfusions (p = 0.04). Admissions for vasoocclusive pain crises and exchange transfusions were not statistically different between cases and controls. SS disease is more severe than SC disease.ConclusionsChildren with concomitant asthma and sickle cell disease have increased episodes of acute chest syndrome, cerebral vascular accidents and the need for blood transfusions. Whether aggressive asthma therapy can reduce these complications in this subset of children is unknown and requires further studies.
Highlights
Asthma and sickle cell disease are common conditions that both may result in pulmonary complications
We examined hospitalized children with sickle cell disease with concomitant asthma establishing whether there was an increased rate of acute chest syndrome or other complications compared to patients with sickle cell disease without asthma in those presenting with vaso-occlusive pain crises
We discovered that children with both asthma and sickle cell disease are significantly more likely to develop severe complications of sickle cell disease including acute chest syndrome and cerebral vascular accidents compared to children with sickle cell disease alone
Summary
Asthma and sickle cell disease are common conditions that both may result in pulmonary complications. We hypothesized that children with sickle cell disease with concomitant asthma have an increased incidence of vaso-occlusive crises that are complicated by episodes of acute chest syndrome. Sickle cell disease is a common debilitating hematologic ease is a major cause of cardiopulmonary disability and (page number not for citation purposes). Progressive restrictive lung disease related to recurrent episodes of acute chest syndrome may develop with advancing age [3]. Acute chest syndrome is a clinical manifestation triggered by pathological processes including infections, fat embolism, infarction and bronchospasm [4]. Hypoxemia causes sickle hemoglobin to gel, inducing red blood cell sickling and vaso-occlusion within pulmonary blood vessels
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