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Computed tomography and pulmonary function abnormalities in sickle cell disease

¹ Division of Asthma, Allergy and Lung Biology, ² Division of Gene and Cell Based Therapy, King's College London School of Medicine at Guy's, King's College & St Thomas' Hospitals, and ³ Depts of Radiology and Interstitial Lung Unit, ⁴ Haematological Medicine, King's College Hospital, and ⁵ Dept of Radiology, Royal Brompton Hospital, London, UK.

CORRESPONDENCE: A. Greenough, Dept of Child Health, 4th Floor Golden Jubilee Wing, King's College Hospital, Denmark Hill, Bessemer Rd, London, SE5 9PJ, UK. Fax: 44 2073468284. E-mail: anne.greenough{at}kcl.ac.uk

Keywords: Haemolysis, high-resolution computed tomography, pulmonary function, sickle cell disease

Received: January 17, 2006
Accepted May 10, 2006

The aim of this study was to determine whether patients with sickle cell disease (SCD) in steady state had pulmonary abnormalities seen on high-resolution computed tomography (HRCT) and whether any abnormalities correlated with contemporaneously diagnosed lung function abnormalities. A subsidiary question was whether the results of a noninvasive measure of haemolysis (end-tidal carbon monoxide (ETCO) levels) correlated with pulmonary function abnormalities.

Thirty three patients with SCD, median (range) age 36 yrs (17–67 yrs) were examined. The degree of lobar volume loss and ground-glass opacification and prominence of central vessels on HRCT were quantitatively assessed. Pulmonary function was assessed by measurements of lung volumes, spirometry, gas transfer and oxygen saturation. ETCO levels were measured using an end-tidal CO monitor.

Forced expiratory volume in one second (FEV₁), forced vital capacity and total lung capacity significantly correlated with HRCT findings, particularly lobar volume loss. ETCO levels significantly negatively correlated with FEV₁, vital capacity measured using a plethysmograph, specific airway conductance and arterial oxygen saturation measured by pulse oxymetry.

In conclusion, the present results suggest that high-resolution computed tomography noninvasive assessment of haemolysis might be useful to identify sickle cell disease patients with respiratory function impairment.