Acute chest syndrome in children with sickle cell disease in Basra, Southern Iraq
Abstract
Objectives: To look for the frequency of acute chest syndrome among children with sickle cell disease, and to evaluate the clinical, hematologic, and radiological features, and outcome of these children.
Methodology: A prospective study was carried out on 154 children with sickle cell disease, who presented with fever and respiratory symptoms. Clinical data were obtained, in addition to pulse oximetry, full blood count and chest x-ray.
Results: Twenty nine sickler children (18.83%) fulfilled the criteria of acute chest syndrome. Dyspnea and chest pain are found to be significant predictors of acute chest syndrome, P < 0.05. In addition to asthma, history of splenectomy and surgery (P= 0.001, and < 0.05 respectively). Hypoxia was present in a significantly higher percent of sickler children with acute chest syndrome (27.58%) compared to patients without acute chest syndrome (4%), P= 0.001. Acute chest syndrome was associated with longer mean duration of hospitalization (2.9±4.3) days compared to those without acute chest syndrome (1.6±1.8) days, P < 0.05.
Conclusions: The frequency of acute chest syndrome is high among sickler children in Basra. Further studies are needed to look for the etiologic factors, recurrence rate and role of hydroxyurea and incentive spirometry in the prevention and treatment of acute chest syndrome.
Methodology: A prospective study was carried out on 154 children with sickle cell disease, who presented with fever and respiratory symptoms. Clinical data were obtained, in addition to pulse oximetry, full blood count and chest x-ray.
Results: Twenty nine sickler children (18.83%) fulfilled the criteria of acute chest syndrome. Dyspnea and chest pain are found to be significant predictors of acute chest syndrome, P < 0.05. In addition to asthma, history of splenectomy and surgery (P= 0.001, and < 0.05 respectively). Hypoxia was present in a significantly higher percent of sickler children with acute chest syndrome (27.58%) compared to patients without acute chest syndrome (4%), P= 0.001. Acute chest syndrome was associated with longer mean duration of hospitalization (2.9±4.3) days compared to those without acute chest syndrome (1.6±1.8) days, P < 0.05.
Conclusions: The frequency of acute chest syndrome is high among sickler children in Basra. Further studies are needed to look for the etiologic factors, recurrence rate and role of hydroxyurea and incentive spirometry in the prevention and treatment of acute chest syndrome.
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