Abstract
A link between cigarette smoking and "acute chest syndrome" in sickle cell anemia is suggested. Acute chest syndrome in the patient with sickle cell anemia is characterized by fever, leukocytosis, cough, chest pain, and pulmonary infiltrates in the chest radiograph. This article describes the results of a study of 69 adolescent and young adult sickle cell anemia patients. Twenty-nine of these patients were smokers, three were former smokers, and 37 were nonsmokers. Patients completed respiratory questionnaires that focused on smoking habits and included a history of chest syndrome. Information obtained was confirmed by review of clinical records. The chi-square test demonstrated a strong relationship between cigarette smoking and chest syndrome in sickle cell anemia. All 29 smokers had a history of chest syndrome, but only 24 of 37 nonsmokers had such a history. Although the exact mechanism of the relationship between smoking and the development of acute chest syndrome remains speculative, cigarette smoking joins infection, hypoxia, acidosis, infarction, dehydration, and analgesics as a causative factor in adolescent and adult patients with sickle cell anemia. Behavioral modification of the smoking habit in patients with sickle cell anemia may decrease the frequency of acute chest syndrome and sequelae of sickle cell lung disease.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bromberg P. A., Jensen W. N. Arterial oxygen unsaturation in sickle cell disease. Am Rev Respir Dis. 1967 Sep;96(3):400–407. doi: 10.1164/arrd.1967.96.3.400. [DOI] [PubMed] [Google Scholar]
- Cole T. B., Sprinkle R. H., Smith S. J., Buchanan G. R. Intravenous narcotic therapy for children with severe sickle cell pain crisis. Am J Dis Child. 1986 Dec;140(12):1255–1259. doi: 10.1001/archpedi.1986.02140260057025. [DOI] [PubMed] [Google Scholar]
- Deneke S. M., Fanburg B. L. Normobaric oxygen toxicity of the lung. N Engl J Med. 1980 Jul 10;303(2):76–86. doi: 10.1056/NEJM198007103030204. [DOI] [PubMed] [Google Scholar]
- Fabry M. E., Benjamin L., Lawrence C., Nagel R. L. An objective sign in painful crisis in sickle cell anemia: the concomitant reduction of high density red cells. Blood. 1984 Aug;64(2):559–563. [PubMed] [Google Scholar]
- GOMORI G. Use of azo dye methods in clinical chemistry and histochemistry. Am J Clin Pathol. 1956 Jan;26(1):1–3. doi: 10.1093/ajcp/26.1.1. [DOI] [PubMed] [Google Scholar]
- Hebbel R. P., Boogaerts M. A., Eaton J. W., Steinberg M. H. Erythrocyte adherence to endothelium in sickle-cell anemia. A possible determinant of disease severity. N Engl J Med. 1980 May 1;302(18):992–995. doi: 10.1056/NEJM198005013021803. [DOI] [PubMed] [Google Scholar]
- Lachant N. A., Oseas R. S. Vaso-occlusive crisis-associated neutrophil dysfunction in patients with sickle-cell disease. Am J Med Sci. 1987 Oct;294(4):253–257. doi: 10.1097/00000441-198710000-00007. [DOI] [PubMed] [Google Scholar]
- Marchesi V. T. Functional proteins of the human red blood cell membrane. Semin Hematol. 1979 Jan;16(1):3–20. [PubMed] [Google Scholar]
- Sowemimo-Coker S. O., Meiselman H. J., Francis R. B., Jr Increased circulating endothelial cells in sickle cell crisis. Am J Hematol. 1989 Aug;31(4):263–265. doi: 10.1002/ajh.2830310409. [DOI] [PubMed] [Google Scholar]
- Warth J. A., Rucknagel D. L. Density ultracentrifugation of sickle cells during and after pain crisis: increased dense echinocytes in crisis. Blood. 1984 Aug;64(2):507–515. [PubMed] [Google Scholar]
- Young R. C., Jr, Castro O., Baxter R. P., Dunn R., Armstrong E. M., Cook F. J., Sampson C. C. The lung in sickle cell disease: a clinical overview of common vascular, infectious, and other problems. J Natl Med Assoc. 1981 Jan;73(1):19–26. [PMC free article] [PubMed] [Google Scholar]
- Young R. C., Jr, Rachal R. E., Reindorf C. A., Armstrong E. M., Polk O. D., Jr, Hackney R. L., Jr, Scott R. B. Lung function in sickle cell hemoglobinopathy patients compared with healthy subjects. J Natl Med Assoc. 1988 May;80(5):509–514. [PMC free article] [PubMed] [Google Scholar]