Prevalence and reversibility of lower airway obstruction in children with sickle cell disease

J Pediatr. 2001 Feb;138(2):188-92. doi: 10.1067/mpd.2001.111824.


Objective: To determine the prevalence and reversibility of lower airway obstruction (LAO) in children and adolescents with hemoglobin SS sickle cell disease (HbSS SCD).

Study design: Retrospective evaluation of lung function in a cross-section of 35 African American and 28 Hispanic children and adolescents with HbSS SCD. Lung function was evaluated with maximal respiratory flow-volume curves and body plethysmography. Each patient was assigned to 1 of 3 patterns of lung function (normal, obstructive, or restrictive). Airway hyperresponsiveness was assessed by means of a trial with bronchodilator.

Results: Normal pattern was detected in 57% of the patients, LAO in 35%, and restrictive lung disease in 8%. Positive response to bronchodilator was documented in 30% of those with normal pattern of lung function, 78% in those with LAO, and 67% of those with restrictive lung disease. The pattern of lung function was not associated with race or with history of vaso-occlusive crises, acute chest syndrome, reactive airways disease/asthma, or long-term transfusion therapy.

Conclusion: Obstructive lung disease possibly precedes the development of restrictive lung disease, and airway reactivity may be part of the pathogenic mechanism.

MeSH terms

  • Adolescent
  • Airway Obstruction / epidemiology
  • Airway Obstruction / etiology*
  • Airway Obstruction / physiopathology
  • Child
  • Hemoglobin SC Disease / complications*
  • Humans
  • Lung Diseases, Obstructive / etiology
  • Maximal Expiratory Flow-Volume Curves
  • Plethysmography, Whole Body
  • Prevalence
  • Retrospective Studies