title: Significant bronchospasm during sickle cell painful crises is associated with a lower peripheral eosinophil count.
abstract: BACKGROUND
  Bronchial hyperresponsiveness and/or bronchospasm are recognized complications of sickle cell disease.
  
  
  OBJECTIVE
  The aim of this study was to investigate the presence of bronchospasm during painful crises, using simple spirometry in patients with sickle cell disease.
  
  
  METHODS
  A prospective, non-randomized study was undertaken in patients with homozygous sickle cell disease, who presented with increasing pain. A painful crisis was defined as any increase in bodily pains necessitating hospital admission. A 15% increase in FEV(1) following salbutamol nebulization was considered significant.
  
  
  RESULTS
  Thirty-nine patients took part in the study. Significant bronchodilator responses were demonstrable in 48.7% of patients during painful crises. Patients with such a response had a significantly lower peripheral blood eosinophil count (mean count 0.17 x 10(9)/L vs. 0.445 x 10(9)/L, P = 0.02, confidence interval for difference between groups, 0.0, 0.39). Furthermore, the magnitudes of the bronchodilator responses were related to the degree of lowering of peripheral blood eosinophil counts (r(s) = -0.344, P = 0.037).
  
  
  CONCLUSIONS
  Significant bronchospasm is demonstrable in a sizeable proportion of patients presenting with painful sickle cell crises. There seems to be a negative correlation between the magnitude of bronchospasm and the peripheral blood eosinophil count. We postulate a possible role for pulmonary sequestration of eosinophils in the pathophysiology of bronchospasm in sickle cell disease patients.
authors.affiliation: Armed Forces Hospital, Southern Region, Khamis Mushayt, Kingdom of Saudi Arabia.
authors.forename: Hilali
authors.initials: H
authors.lastname: Hassan
authors.forename: Inam
authors.initials: I
authors.lastname: Mughal
authors.forename: Javeed
authors.initials: J
authors.lastname: Dar
authors.forename: Taj E
authors.initials: TE
authors.lastname: Al Mekki
authors.forename: Zivani
authors.initials: Z
authors.lastname: Chapunduka
authors.forename: Ahmad
authors.initials: A
authors.lastname: Haddad
authors.forename: Imad S A
authors.initials: IS
authors.lastname: Hassan
mesh_terms: D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000503:physiopathology*; D001986:Bronchial Spasm / Q000503:physiopathology*; D004804:Eosinophils / Q000502:physiology; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D011446:Prospective Studies; D013147:Spirometry