Computed tomography and pulmonary function abnormalities in sickle cell disease

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

^* To whom correspondence should be addressed. E-mail: anne.greenough{at}kcl.ac.uk.

	Abstract

To determine whether patients with sickle cell disease (SCD) in steady state had pulmonary abnormalities seen on high resolution computed tomography (HRCT) and if any abnormalities correlated with contemporaneously diagnosed lung function abnormalities. A subsidiary question was whether the results of a non invasive measure of haemolysis (end tidal carbon monoxide (ETCO) levels) corrected with pulmonary function abnormalities.

Thirty three patients with SCD, median age 36 (range 17-67) years 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.

FEV₁ (p<0.05), FVC (p<0.005) and TLC (p=0.008) correlated with HRCT findings, particularly lobar volume loss. ETCO levels negatively correlated with FEV₁ (p=0.006), VC_pleth (p=0.006), sGaw (p=0.04) and S_pO₂ (p=0.007).

Our results suggest that HRCT non-invasive assessment of haemolysis might be useful to identify SCD patients with respiratory function impairment.