Research

Asthma is a risk factor for acute chest syndrome and cerebral vascular accidents in children with sickle cell disease

Mark E Nordness^1,2 , John Lynn³ , Michael C Zacharisen⁴ , Paul J Scott⁵ and Kevin J Kelly⁶

¹  Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA

²  Prohealth Care Medical Center, N17 W24100 Riverwood Drive, Suite 150, Waukesha, Wisconsin, 53188, USA

³  Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA

⁴  Department of Pediatrics, Children's Research Institute, Medical College of Wisconsin, Milwaukee, Wisconsin, USA

⁵  Department of Pediatrics, Children's Research Institute, Medical College of Wisconsin, Blood Center of Southeastern Wisconsin, Milwaukee, Wisconsin, USA

⁶  Department of Pediatrics, Children's Research Institute, Medical College of Wisconsin, Milwaukee, Wisconsin, USA

author email corresponding author email

Clinical and Molecular Allergy 2005, 3:2doi:10.1186/1476-7961-3-2

Published:	21 January 2005

Abstract

Background

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.

Methods

A 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.

Results

Children 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.

Conclusions

Children 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.