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The intersection between asthma and acute chest syndrome in children with sickle-cell anaemia
Michael R DeBaun1, Robert C Strunk2
1Department of Pediatrics and Medicine, Division of Hematology/Oncology, Nashville, TN, USA; Vanderbilt-Meharry Sickle Cell Center for Excellence, Vanderbilt University School of Medicine, Nashville, TN, USA.
Insights
Asthma is common in children with sickle cell disease and shares symptoms with acute chest syndrome. Differentiating these conditions is crucial for appropriate, disease-specific management in pediatric patients.
Area of Science:
- Pediatric Pulmonology
- Hematology
Background:
- Asthma is a frequent comorbidity in children with sickle cell disease.
- Asthma exacerbations in these children are linked to increased pain events, acute chest syndrome, and mortality.
Observation:
- Asthma and acute chest syndrome share similar risk factors and clinical presentations, including shortness of breath, chest pain, cough, and wheezing.
- These overlapping features can complicate diagnosis and management.
Findings:
- Acute chest syndrome is a significant cause of acute lung disease in pediatric sickle cell disease patients.
- Asthma and acute chest syndrome are distinct clinical entities requiring tailored management strategies.
Implications:
- Accurate differentiation between asthma exacerbation and acute chest syndrome is critical for effective treatment in children with sickle cell disease.
- Further research is needed to establish optimal management protocols for asthma as a comorbidity in sickle cell disease.
- Improved understanding can reduce morbidity and mortality associated with these overlapping conditions.
Abstract:
Acute chest syndrome is a frequent cause of acute lung disease in children with sickle-cell disease. Asthma is common in children with sickle-cell disease and is associated with increased incidence of vaso-occlusive pain events, acute chest syndrome episodes, and earlier death. Risk factors for asthma exacerbation and an acute chest syndrome episode are similar, and both can present with shortness of breath, chest pain, cough, and wheezing. Despite overlapping risk factors and symptoms, an acute exacerbation of asthma or an episode of acute chest syndrome are two distinct entities that need disease-specific management strategies. Although understanding has increased about asthma as a comorbidity in sickle-cell disease and its effects on morbidity, substantial gaps remain in knowledge about best management.
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