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Aeroallergen sensitization predicts acute chest syndrome in children with sickle cell anaemia

Shaina M Willen1, Mark Rodeghier2, Robert C Strunk3

  • 1Department of Pediatrics, Division of Hematology/Oncology, Vanderbilt-Meharry Center for Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, TN, USA.

British Journal of Haematology
|January 25, 2018
PubMed

Insights

Children with sickle cell anaemia (SCA) and allergies to airborne triggers (aeroallergen sensitization) face a higher risk of acute chest syndrome (ACS) hospitalizations. Identifying and managing these allergies may reduce ACS risk in children with SCA.

Area of Science:

  • Pediatric Hematology
  • Allergy and Immunology
  • Pulmonology

Background:

  • Asthma is linked to increased acute chest syndrome (ACS) and pain episodes in children with sickle cell anaemia (SCA).
  • Aeroallergen sensitization is a known risk factor for asthma, suggesting a potential link to SCA complications.

Purpose of the Study:

  • To investigate the association between aeroallergen sensitization and the incidence of hospitalizations for ACS and pain in children with SCA.
  • To determine if the number of positive skin tests for aeroallergens predicts future ACS and pain episodes.

Main Methods:

  • A multicentre, longitudinal cohort study involving children with SCA aged 4-18 years.
  • Skin prick testing to ten aeroallergens was performed.
  • Prospective data collection on ACS and pain episodes from birth to follow-up end.

Main Results:

  • Each positive aeroallergen skin test was associated with a 23% increased incidence rate of future ACS hospitalizations (IRR 1.23, P < 0.001).
  • Aeroallergen sensitization was not significantly associated with future pain episodes (IRR 1.14, P = 0.11).

Conclusions:

  • Children with SCA and aeroallergen sensitization have an elevated risk of future ACS.
  • Further research is warranted to explore allergen avoidance and treatment strategies to mitigate ACS risk in this population.

Keywords:
Allergyacute chest syndromeasthmaatopysickle cell anaemia

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