Acute reversible pulmonary ischemia. A cause of the acute chest syndrome in sickle cell disease.
A 6-year-old girl with sickle cell disease was admitted to the hospital with the diagnosis of the acute chest syndrome. The laboratory findings and the radionuclear lung scan supported a diagnosis of pulmonary infarction rather than pneumonia. She improved with intravenous fluids, oxygen, penicillin, and theophylline. The most likely explanation for the rapid resolution of the clinical syndrome, the chest x-ray, and lung scan abnormalities is that masses of sickled cells caused transient pulmonary vascular occlusion leading to perfusion defects and ischemia, and that the sickled cell thrombi were dislodged before the infarction occurred. To our knowledge, this phenomenon has not been described as a cause of the acute chest syndrome in sickle cell disease in children.
D000208:Acute Disease; D000755:Anemia, Sickle Cell / Q000150:complications*; D002648:Child; D005260:Female; D006801:Humans; D007238:Infarction / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D008168:Lung / Q000098:blood supply* / Q000000981:diagnostic imaging; D011877:Radionuclide Imaging; D013577:Syndrome; D013668:Technetium Tc 99m Aggregated Albumin; D013806:Theophylline / Q000627:therapeutic use
D013668:Technetium Tc 99m Aggregated Albumin; D013806:Theophylline