Chest crisis in children under 18 years of age with sickle cell anemia

Abstract

Introduction: Acute chest syndrome (ACS) is one of the leading causes of respiratory distress and hospitalization in children with sickle cell anemia.

Objective: To Characterize children with vaso-occlusive crisis of sickle cell anemia who developed an acute chest syndrome.

Methods: A descriptive, cross-sectional, and retrospective study was conducted from January 2023 to December 2025. The universe consisted of 68 patients diagnosed with vaso-occlusive crisis of sickle cell anemia; and the sample was made up of 48 patients with said diagnosis, selected probabilistically by simple random sampling.

Results: Increasing the mean age increased the risk of developing acute chest syndrome (p<0.01). A statistically significant association was found between acute chest syndrome and a temperature of 38.5 °C or higher within the first 24 hours of admission (OR = 6.8; 95.0 % CI: 1.54–30.1; p = 0.006), a history of bronchial asthma (OR = 7.8; 95.0 % CI: 1.51–40.8; p = 0.007), and a white blood cell count of 14 x 10⁹/L or higher (OR = 5.2; 95% CI: 1.27–21.2; p = 0.016). Prior use of hydroxyurea was a protective factor (OR = 0.1; 95.0 % CI: 0.20–0.43; p = 0.009).

Conclusions: The clinical characteristics in terms of sex, average age of onset, and risk factors for the development of acute chest syndrome in the case series do not differ from the global epidemiological context.