Abstract
In this study the records of 45 patients with sickle cell disease involved in 63 presentations of acute chest syndrome at the Princess Margaret Hospital in Nassau, the Bahamas, between 1997 and 2001 were examined. Patients were divided into three groups on the basis of age (<13 years, 13–18 years, ⩾19 years) with a view to assessing clinical presentation. The incidence of symptoms, physical signs, and laboratory findings were enumerated and significant differences between age groups determined. The data were analysed using analysis of variance, t test, and χ2 test and compared with existing knowledge on the subject.
This study proposed to evaluate the clinical presentation of acute chest syndrome with emphasis on historical and physical findings, and to encourage the physician to maintain a high index of suspicion for the condition in susceptible patients. It was found that presentation varied significantly with age groups, children presenting most classically with fever and cough and adults, with chest pain. The 13–18 age group emerged as the group which presented most frequently with the typical symptoms of chest infection, thus potentially making diagnosis easier. Of note, the most frequent finding was a normal examination, while the second commonest physical finding was crepitations on auscultation of the chest.
Full Text
The Full Text of this article is available as a PDF (89.6 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Barrett-Connor E. Pneumonia and pulmonary infarction in sickle cell anemia. JAMA. 1973 May 14;224(7):997–1000. [PubMed] [Google Scholar]
- Gray A., Anionwu E. N., Davies S. C., Brozovic M. Patterns of mortality in sickle cell disease in the United Kingdom. J Clin Pathol. 1991 Jun;44(6):459–463. doi: 10.1136/jcp.44.6.459. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Oppenheimer E. H., Esterly J. R. Pulmonary changes in sickle cell disease. Am Rev Respir Dis. 1971 Jun;103(6):858–859. doi: 10.1164/arrd.1971.103.6.858. [DOI] [PubMed] [Google Scholar]
- Poncz M., Kane E., Gill F. M. Acute chest syndrome in sickle cell disease: etiology and clinical correlates. J Pediatr. 1985 Dec;107(6):861–866. doi: 10.1016/s0022-3476(85)80176-1. [DOI] [PubMed] [Google Scholar]
- Quinn C. T., Buchanan G. R. The acute chest syndrome of sickle cell disease. J Pediatr. 1999 Oct;135(4):416–422. doi: 10.1016/s0022-3476(99)70162-9. [DOI] [PubMed] [Google Scholar]
- Sprinkle R. H., Cole T., Smith S., Buchanan G. R. Acute chest syndrome in children with sickle cell disease. A retrospective analysis of 100 hospitalized cases. Am J Pediatr Hematol Oncol. 1986 Summer;8(2):105–110. [PubMed] [Google Scholar]
- Thomas A. N., Pattison C., Serjeant G. R. Causes of death in sickle-cell disease in Jamaica. 1982 Aug 28-Sep 4Br Med J (Clin Res Ed) 285(6342):633–635. doi: 10.1136/bmj.285.6342.633. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Vichinsky E. P., Neumayr L. D., Earles A. N., Williams R., Lennette E. T., Dean D., Nickerson B., Orringer E., McKie V., Bellevue R. Causes and outcomes of the acute chest syndrome in sickle cell disease. National Acute Chest Syndrome Study Group. N Engl J Med. 2000 Jun 22;342(25):1855–1865. doi: 10.1056/NEJM200006223422502. [DOI] [PubMed] [Google Scholar]
- Vichinsky E. P., Styles L. A., Colangelo L. H., Wright E. C., Castro O., Nickerson B. Acute chest syndrome in sickle cell disease: clinical presentation and course. Cooperative Study of Sickle Cell Disease. Blood. 1997 Mar 1;89(5):1787–1792. [PubMed] [Google Scholar]
- Vichinsky E., Styles L. Pulmonary complications. Hematol Oncol Clin North Am. 1996 Dec;10(6):1275–1287. doi: 10.1016/s0889-8588(05)70400-7. [DOI] [PubMed] [Google Scholar]
- Yale S. H., Nagib N., Guthrie T. Acute chest syndrome in sickle cell disease. Crucial considerations in adolescents and adults. Postgrad Med. 2000 Jan;107(1):215-8, 221-2. doi: 10.3810/pgm.2000.01.835. [DOI] [PubMed] [Google Scholar]
- van Agtmael M. A., Cheng J. D., Nossent H. C. Acute chest syndrome in adult Afro-Caribbean patients with sickle cell disease. Analysis of 81 episodes among 53 patients. Arch Intern Med. 1994 Mar 14;154(5):557–561. doi: 10.1001/archinte.154.5.557. [DOI] [PubMed] [Google Scholar]