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Abnormal pulmonary function in adults with sickle cell anemia.

Elizabeth S Klings1, Diego F Wyszynski, Vikki G Nolan

  • 1Pulmonary Center, Department of Medicine, Boston Comprehensive Sickle Cell Center, Boston University School of Medicine and School of Public Health, Boston, MA 02118, USA. eklings@lung.bumc.bu.edu

American Journal of Respiratory and Critical Care Medicine
|March 25, 2006
PubMed
Summary

Pulmonary function tests reveal that 90% of adults with sickle cell anemia (Hb-SS) have abnormalities, primarily restrictive physiology and reduced diffusion capacity for carbon monoxide (DLCO). These findings may signal more severe sickle vasculopathy.

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Area of Science:

  • Pulmonary Medicine
  • Hematology
  • Cardiopulmonary Function

Background:

  • Pulmonary complications are a significant cause of morbidity in sickle cell anemia (Hb-SS).
  • Large-scale studies on pulmonary function tests (PFTs) in this population are limited.
  • Understanding pulmonary dysfunction is crucial for managing Hb-SS patients.

Purpose of the Study:

  • To analyze PFTs in a large cohort of adults with Hb-SS.
  • To determine the prevalence and patterns of pulmonary dysfunction.
  • To investigate the association between pulmonary dysfunction and other systemic complications.

Main Methods:

  • Analysis of spirometry, lung volumes, and DLCO in 310 adults with Hb-SS.
  • Comparison of PFT data with predicted values.

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  • Classification of subjects into obstructive, restrictive, mixed, isolated low DLCO, or normal groups.
  • Multivariate linear regression to assess associations between PFT abnormalities and laboratory data.
  • Main Results:

    • Only 10% of patients had normal PFTs.
    • Common abnormalities included restrictive physiology (74%) and decreased DLCO (13%).
    • Reduced DLCO was associated with thrombocytosis, hepatic dysfunction, and trends toward renal dysfunction.

    Conclusions:

    • Pulmonary function is abnormal in 90% of adult Hb-SS patients.
    • Restrictive physiology and decreased DLCO are the most frequent PFT abnormalities.
    • Decreased DLCO may indicate more severe sickle vasculopathy with hepatic and renal impairment.