Pattern of lung function is not associated with prior or future morbidity in children with sickle cell anemia

Abstract

Rationale: Patient factors associated with development of abnormal lung function in children with sickle cell anemia (SCA) have not been fully characterized.

Objectives: To characterize lung function abnormalities among children with SCA and to determine whether these steady-state lung function results were associated with morbidity before or after testing among children with SCA.

Methods: This study was part of the prospective National Institutes of Health–funded Sleep and Asthma Cohort Study. Children with HbSS or Hb S?o (SCA) were enrolled without regard for sickle cell–related comorbidities or diagnosis of asthma. Lung function was measured by spirometry and plethysmography on the same day, when free of acute disease. Standardized asthma symptom questionnaires and review of the medical records were also performed.

Measurements and Main Results: A total of 149 children aged 6 to 19 years completed lung function testing, of whom 139 participants had retrospective morbidity data from birth to the test date, and 136 participants were followed prospectively for a median of 4.3 years from the test date. At baseline, percentages with normal, obstructive, restrictive, nonspecific, and mixed lung function patterns were 70, 16, 7, 6, and 1, respectively. Neither retrospective rates of pain nor acute chest syndrome was associated with lung function patterns. Furthermore, baseline lung function pattern was not predictive of future pain or acute chest syndrome episodes.

Conclusions: The majority of children with SCA have lung function that is within the normal range. Abnormal lung function patterns were not associated with prior vasoocclusive pain or acute chest syndrome episodes, and baseline lung function patterns did not predict future vasoocclusive pain or chest syndrome episodes.

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ORCID for F.J. Kirkham: orcid.org/0000-0002-2443-7958

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