title: Association between adenotonsillar hypertrophy, tonsillitis and painful crises in sickle cell disease.
abstract: OBJECTIVE
  To determine the prevalence of obstructive adenotonsillar hypertrophy in children and adolescents with sickle cell anemia; to investigate possible association between the presence of more than five episodes of tonsillitis in the last 12 months and episodes of painful crises in the same period; and to compare the mean annual hemoglobin level in children and adolescents with and without obstructive adenotonsillar hypertrophy.
  
  
  METHODS
  Prospective, observational, cross-sectional study involving 85 children and adolescents with sickle cell anemia. All patients answered a questionnaire and underwent a standard otolaryngology examination, including endoscopic endonasal approach. The diagnosis of obstructive adenotonsillar hypertrophy was made according to the Brodsky scale.
  
  
  RESULTS
  The prevalence of obstructive adenotonsillar hypertrophy was 55.3%. Obstructive adenotonsillar hypertrophy was associated with history of difficulty in eating (76.7 vs. 23.5%, p = 0.003), presence of more than five episodes of tonsillitis in the last 12 months (70.6 vs. 29.4%, p = 0.021), loud snoring (73.0 vs. 27.0%, p = 0.004), and sleep apnea (71.8 vs. 28.2%, p = 0.005). Patients with obstructive adenotonsillar hypertrophy had more episodes of recurrent upper airway tract infection (62.5 vs. 37.5; p = 0.010). The presence of more than five episodes of tonsillitis in the last 12 months was associated with episodes of painful crises (median = 12 vs. 2, p = 0.017). There was no significant difference between mean annual hemoglobin levels of patients with obstructive adenotonsilar hypertrophy vs. nonobstructive adenotonsillar hypertrophy: 7.6 vs. 8.2 g/dL, p = 0.199.
  
  
  CONCLUSIONS
  The prevalence of obstructive adenotonsillar hypertrophy was 55.3% in children and adolescents with sickle cell anemia; the presence of more than five episodes of tonsillitis in the last 12 months was associated with episodes of painful crises in the same period; and there was no difference in the mean annual hemoglobin value among those with or without obstructive adenotonsillar hypertrophy.
authors.affiliation: Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil. cristinasalles@click21.com.br
authors.forename: Cristina
authors.initials: C
authors.lastname: Salles
authors.forename: Regina Terse T
authors.initials: RT
authors.lastname: Ramos
authors.forename: Carla
authors.initials: C
authors.lastname: Daltro
authors.forename: Valma Maria
authors.initials: VM
authors.lastname: Nascimento
authors.forename: Marcos Almeida
authors.initials: MA
authors.lastname: Matos
mesh_terms: D000234:Adenoids / Q000473:pathology*; D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000097:blood / Q000150:complications*; D001938:Brazil / Q000453:epidemiology; D002648:Child; D004812:Epidemiologic Methods; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D006984:Hypertrophy / Q000453:epidemiology / Q000473:pathology; D008297:Male; D010146:Pain / Q000150:complications* / Q000453:epidemiology; D014066:Palatine Tonsil / Q000473:pathology*; D014069:Tonsillitis / Q000150:complications* / Q000453:epidemiology
chemical_list: D006454:Hemoglobins