Abstract

ROQUE GARCIA, Wilfredo; SVARCH, Eva; QUESADA LAFERTE, Yaimir  and  GUTIERREZ DIAZ, Adys. Acute chest syndrome in children with sickle cell disease at the Institute of Hematology and Immunology. Rev Cubana Hematol Inmunol Hemoter [online]. 2014, vol.30, n.2, pp.137-145. ISSN 0864-0289.

Introduction: acute chest syndrome describes new respiratory symptoms and new pulmonary infiltrate in chest radiograph in patients with sickle cell disease, and is the second most common cause of hospitalization in these children Objectives: to get acquainted with clinical and laboratory features and the treatment used in each episode of acute chest syndrome. Methods: an ambispective and analitic study was conducted involving 112 episodes of acute chest syndrome in 62 patients admitted to the Pediatric Service of the Institute of Hematology and Inmunology from January 1^st 2005 through July 30^th 2012. Results: the syndrome was more frequent in male children (58,06 %) between 5 - 9 years old and in sickle cell anemia patients (67,85 %). Only one episode occurred in 54,8 % of the children and the rest presented two or more. Fever, chest pain and cough were the main features at diagnosis. X-ray findings showed that the right lung base was involved in 52 % of the cases. All our patients received antibiotic, mainly cefotaxima, azitromicin and ceftriaxone. In 83 episodes blood therapy was applied. We found statistical correlation between white cell count at diagnosis and the severity of the episode (p = 0.009). No mortality associated to acute chest syndrome occurred. Conclusions: the acute chest syndrome was present in the patients studied with similar characteristics reported by other authors. A correct health education to patientes and family members, together with a precise and early diagnosis and treatment directed by a specialized medical team were significant for the survival of all our patients.

Keywords : sickle cell anemia; sickle cell disease; acute chest syndrome.

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