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Published on: April 13, 2010
Airway hyperresponsiveness in children with sickle cell anemia
Joshua J Field1, Janet Stocks2, Fenella J Kirkham3
1Department of Medicine, Washington University School of Medicine, St. Louis, MO.
Chest
|August 21, 2010
Summary
Airway hyperresponsiveness (AHR) is common in children with sickle cell anemia (SCA). Younger age, IgE, and lactate dehydrogenase (LDH) levels are linked to AHR, suggesting SCA-related factors contribute.
Area of Science:
- Pediatric Pulmonology
- Hematology
- Allergy and Immunology
Background:
- Airway hyperresponsiveness (AHR) is frequently observed in children with sickle cell anemia (SCA).
- The underlying causes for AHR in this pediatric population are not well understood.
Purpose of the Study:
- To investigate the relationship between AHR, asthma indicators, and clinical features in children with SCA.
- To identify predictors of methacholine responsiveness in pediatric SCA patients.
Main Methods:
- A multicenter, prospective cohort study involving children with SCA.
- Methacholine challenge testing was used to assess airway responsiveness, calculating the dose-response slope (DRS).
- Multiple linear regression analysis identified independent predictors of DRS.
Main Results:
- Methacholine challenge was performed on 99 children with SCA (median age 12.8 years).
- 55% of children exhibited significant methacholine responsiveness (provocative concentration < 4 mg/mL).
- Independent predictors of increased methacholine responsiveness included younger age, elevated serum IgE, and higher lactate dehydrogenase (LDH) levels.
Conclusions:
- AHR to methacholine is prevalent in children with SCA.
- Younger age, serum IgE, and LDH levels (a marker of hemolysis) are associated with AHR.
- SCA-related factors, indicated by LDH, may contribute to AHR, warranting further investigation.
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