title: Pattern of chronic lung lesions in adults with sickle cell disease in Lagos, Nigeria.
abstract: BACKGROUND
  The vascular response to recurrent tissue hypoxia and reperfusion following red blood cell sickling causes acute chest syndrome and chronic lung disease. The purpose of this study was to determine the pattern of chronic lung lesions and possible risk factors in sickle cell patients in lagos, Nigeria.
  
  
  METHODS
  From July 2012 to April 2013, Pulmonary function test (PFT) and chest-x-ray were determined in 56 eligible patients with sickle cell disease. Full blood count, red cell indices, hemoglobin F level, oxygen saturation, liver function tests, lactate dehydrogenase and tricuspid regurgitant jet velocity were measured.
  
  
  RESULTS
  The mean age of the patients was 22±6 years. The mean forced vital capacity was low (76.49%±16). Abnormal PFTs were restrictive lung lesion (53%), obstructive lesions (3.7%) and mixed lesions (11%). The vital capacity had negative correlation with the white cell count and platelet count while it had positive correlation with age. There were no significant differences when normal and abnormal PFTs were compared based on the following laboratory data: lactate dehydrogenase (244 vs. 301), hematocrit (22.7 vs. 23.6), fetal hemoglobin (6.2% vs. 4.2%), mean corpuscular hemoglobin concentration (33.7 vs 33.3), aspartate transferase (34.2 vs. 35.1), tricuspid regurgitant jet velocity (1.3 vs. 0.92) and oxygen saturation (95.8 vs. 95.5). Abnormal x-ray findings were present in 84% of participants. Chest x ray showed ischemic (17%), congestive (69%), fibrotic and inflammatory (14%) changes.
  
  
  CONCLUSIONS
  Chronic lung lesion is common in sickle cell disease associated with rising white cell count, platelet count. All adult patients should have regular spirometry done to ensure early detection.
authors.affiliation: Department of Hematology and Blood Transfusion, Lagos State University, College of Medicine, Ikeja, Nigeria.
authors.forename: Adedoyin
authors.initials: A
authors.lastname: O Dosunmu
authors.forename: Rachael
authors.initials: R
authors.lastname: A Akinola
authors.forename: Josephine
authors.initials: J
authors.lastname: A Onakoya
authors.forename: Taiwo
authors.initials: T
authors.lastname: M Balogunt
authors.forename: Olufunke
authors.initials: O
authors.lastname: O Adeyeye
authors.forename: Akinsegun
authors.initials: A
authors.lastname: A Akinbami
authors.forename: Olanrewaju
authors.initials: O
authors.lastname: M Arogundade
authors.forename: Ayodeji
authors.initials: A
authors.lastname: T Brodie-Mends
keywords: Jet velocity; Regurgitant; Sickle cell disease; Spirometry.; Tricuspid