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. 2006 Nov 1;108(9):2923-7.
doi: 10.1182/blood-2006-01-011072. Epub 2006 May 11.

Asthma is associated with acute chest syndrome and pain in children with sickle cell anemia

Jessica H Boyd  1 , Eric A Macklin, Robert C Strunk, Michael R DeBaun
Affiliations

Asthma is associated with acute chest syndrome and pain in children with sickle cell anemia

Jessica H Boyd et al. Blood. .

Abstract

Pain and acute chest syndrome (ACS) episodes are 2 of the most common causes of hospitalization in children with sickle cell anemia (SCA). However, very few potentially modifiable risk factors for either condition have been identified. In this prospective infant cohort study, we tested the hypothesis that asthma is associated with an increased incidence rate of pain and ACS episodes. An infant cohort was composed of 291 African American children with hemoglobin SS enrolled in the Cooperative Study for Sickle Cell Disease before age 6 months and followed beyond age 5 years. Asthma was defined by a physician diagnosis, an acute asthma event, or use of prescription asthma medications. The incidence rates of ACS and painful episodes were compared for children with and without asthma. A clinical diagnosis of asthma was made in 17% of the cohort. Asthma was associated with more frequent ACS episodes (0.39 vs 0.20 events per patient year, P < .001) and painful episodes (1.39 vs 0.47 events per patient year, P < .001). In conclusion, in children with SCA, asthma is associated with an increased incidence of sickle cell disease-related morbidity, including ACS and painful episodes.

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Figures

Figure 1.
Figure 1.
Enrollment in the infant sickle cell anemia cohort and eligibility for study cohort.
Figure 2.
Figure 2.
Age-specific incidence of acute chest syndrome (ACS) and pain events classified by clinical asthma status in the infant sickle cell anemia (SCA) cohort. (A) Overall incidence rate of ACS events is higher in children with SCA and asthma (0.39 events per patient year) when compared with children with SCA and without asthma (0.20 events per patient year; P < .001). (B) Overall incidence rate of painful events is higher in children with SCA and asthma (1.39 events per patient year) when compared with children with SCA and without asthma (0.47 events per patient year, P < .001). Line segments are point-wise exact 95% confidence intervals.
Figure 3.
Figure 3.
Kaplan-Meier plot of time to first ACS event in the sickle cell anemia (SCA) infant cohort. Numbers below the x-axis list the number of children with SCA at risk at each 2-year interval. Exact log-rank, P = .002.
See this image and copyright information in PMC

References

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