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Blood, 1 November 2006, Vol. 108, No. 9, pp. 2923-2927.
Prepublished online as a Blood First Edition Paper on May 11, 2006; DOI 10.1182/blood-2006-01-011072.


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Submitted January 30, 2006
Accepted April 17, 2006

Asthma is associated with acute chest syndrome and pain in children with sickle cell anemia

Jessica H Boyd, Eric A Macklin, Robert C Strunk, and Michael R DeBaun*

Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
New England Research Institutes, Watertown, MA, USA

* Corresponding author; email: debaun_m{at}kids.wustl.edu.

Pain and acute chest syndrome (ACS) episodes are two of the most common causes of hospitalization in children with sickle cell anemia (SCA). However, very few potentially modifiable risks factors for either condition have been identified. In this prospective infant cohort study, we tested the hypothesis that asthma is associated with an increased incidence rate of pain and ACS episodes. An infant cohort was comprised of 291 African-American children with hemoglobin SS enrolled in the Cooperative Study for Sickle Cell Disease (CSSCD) before age six months and followed beyond age five-years. Asthma was defined by a physician diagnosis, an acute asthma event, or use of prescription asthma medications. The incidence rates of ACS episodes and painful events were compared for children with and without asthma. A clinical diagnosis of asthma was made in 17% of the cohort. Asthma was associated with more frequent ACS episodes (0.39 v. 0.20 events per patient-year, p<0.001) and painful episodes (1.39 v. 0.47 events per patient-year, p<0.001). In conclusion, in children with SCA, asthma is associated with an increased incidence of sickle cell disease- related morbidity, including ACS and painful episodes.


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