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Respiratory pathogens and acute chest syndrome in children with sickle cell disease

Marie-Caroline Ploton1,2, Julie Sommet3, Bérengère Koehl4

  • 1Department of General Pediatrics and infectious diseases, Hôpital Universitaire Robert-Debré, Paris, France.

Archives of Disease in Childhood
|April 10, 2020
PubMed

Insights

In children with sickle cell disease (SCD), viral respiratory infections are common but not linked to acute chest syndrome (ACS). This study found no association between viral pathogens and ACS in pediatric SCD patients.

Area of Science:

  • Pediatric Hematology
  • Infectious Diseases
  • Respiratory Medicine

Background:

  • Acute chest syndrome (ACS) is a complication in children with sickle cell disease (SCD).
  • The epidemiology of viral and intracellular respiratory pathogens causing fever and/or ACS in pediatric SCD patients is not well-established.
  • Understanding these pathogens is crucial for managing SCD complications.

Purpose of the Study:

  • To determine the epidemiology of viral and intracellular respiratory pathogens in children with SCD presenting with fever and/or ACS.
  • To investigate the association between specific respiratory pathogens and the occurrence of ACS in this population.

Main Methods:

  • An observational, prospective, single-center cohort study.
  • 101 children with SCD admitted for fever and/or ACS were screened for 20 respiratory pathogens using multiplex PCR (FilmArray).
  • A nested case-control analysis compared children with ACS to those without.

Main Results:

  • At least one pathogen was detected in 67% of children.
  • The most common viruses were rhinovirus (33), adenovirus (14), RSV (13), and parainfluenza (11).
  • No statistical association was found between viral detection and ACS (p=0.51), although parainfluenza viruses were more frequent in ACS cases.

Conclusions:

  • Viral detection is frequent in febrile children with SCD, but a direct association with ACS was not demonstrated in this study.
  • Mycoplasma pneumoniae was infrequently detected in young children with SCD experiencing ACS.
  • Further research may be needed to elucidate the specific triggers of ACS in pediatric SCD patients.
Abstract

Keywords:
epidemiologygeneral paediatricshaematologyinfectious diseasesvirology

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