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Association of Asthma with Acute Vaso-Occlusive Crisis Among French Guianese Children with Sickle Cell Disease
Gabriel Bafunyembaka1, Mathieu Nacher2, Chimène Maniassom3
1Department of Pediatrics, Franck Joly Hospital, Western French Guiana, Avenue Paul Castaing Saint-Laurent du Maroni GF 97320, Guyane Française, French Guiana, France.
Insights
Children with sickle cell disease (SCD) and asthma experience more hospitalizations for pain crises. Asthma exacerbations often coincide with sickle cell crises, increasing healthcare needs.
Area of Science:
- Pediatric Hematology
- Pulmonology
- Epidemiology
Background:
- Sickle cell disease (SCD) is a genetic blood disorder causing severe pain crises.
- Asthma is a chronic respiratory condition affecting millions of children.
- The impact of co-occurring asthma on SCD complications is not fully understood.
Purpose of the Study:
- To investigate how asthma affects hospitalizations for vaso-occlusive pain episodes in children with SCD.
- To quantify the increased risk of hospitalizations and specific complications in children with both SCD and asthma.
Main Methods:
- A multicenter nested case-control study was conducted from 2012 to 2022.
- Included 600 children with SCD, with 35 diagnosed with asthma (5.8% prevalence).
- Compared hospitalization rates and causes between children with and without asthma.
Main Results:
- Children with both SCD and asthma had significantly more hospitalizations (median 6 vs. 2) for pain crises (p < 0.001).
- Asthma exacerbations coincided with sickle cell crises in 90% of cases.
- Acute chest syndrome incidence was 18 times higher; vaso-occlusive crises were 3.99 times more likely to require hospitalization.
Conclusions:
- Co-morbidity of asthma in children with SCD leads to a substantially higher frequency of hospitalizations for vaso-occlusive crises.
- Asthma exacerbates SCD, increasing the risk of severe pain episodes and acute chest syndrome.
- Integrated management strategies are crucial for children with both sickle cell disease and asthma.
Objectives:
To evaluate the impact of asthma on hospitalizations for acute vaso-occlusive pain episodes in children with sickle cell disease (SCD).
Methods:
A multicenter nested case-control study was conducted over a period from January 1, 2012, to December 31, 2022.
Results:
The mean age of the study population was 8.41 ± 5.04 y, with an equal distribution of males and females. Among the 600 children with SCD included in the study, 35 were diagnosed with asthma, yielding a prevalence of 5.8%. Children with both SCD and asthma had a median of 6 hospitalizations (Range: 2-20), compared to 2 (Range: 1-4) in those without asthma (p < 0.001). In 90% of these cases, asthma exacerbation coincided with a sickle cell crisis. Besides vaso-occlusive episodes, other leading causes of hospitalization included pulmonary infections and acute chest syndrome. The incidence of acute chest syndrome was found to be 18 times higher in children with both asthma and sickle cell disease. Furthermore, children with both conditions were 3.99 times more likely to experience a vaso-occlusive crisis requiring hospitalization than those without asthma.
Conclusions:
Children with sickle cell disease and asthma co-morbidity experience a significantly higher number of vaso-occlusive crises requiring hospitalization.
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