Pediatr Radiol 1997 Aug;27(8):637-641. Acute chest syndrome of sickle cell disease: radiographic and clinical analysis of 70 cases.
Martin L, Buonomo C
BACKGROUND: Acute chest syndrome (ACS) is a pulmonary illness with fever,
chest pain, leukocytosis and new
pulmonary opacity in a patient with sickle cell disease. It is a common
reason for hospitalization in sickle cell patients,
and a significant cause of mortality. The etiology of ACS is unclear.
Lung or bone infarction and infection, among other
possible causes, have been proposed. OBJECTIVE: We reviewed the chest
radiographs and medical records of 41
patients with 70 episodes of ACS and correlated the clinical and radiographic
courses in an attempt to better
characterize and understand the syndrome. RESULTS: In 87 % of episodes,
no identifiable etiology of ACS was found.
This group of patients had a median age of 14 years and showed dramatic
clinical and radiographic improvement within
24 h of therapy. In the remainder of episodes (13 %), an identifiable
etiology was found, usually bacterial pneumonia.
These patients were younger than the group without an identifiable
etiology (median age 2 years) and had a prolonged
radiographic course of illness. CONCLUSION: The chest radiographs of
children with ACS without an identifiable
etiology have an extremely typical appearance and evolution. Only in
cases which do not have this typical pattern should
infection be suspected as the underlying cause.
PMID: 9252426, UI: 97400601
