Lung Function Tests in Sickle-Cell Patients in Benin City

Abstract

Background. Sickle-cell disease (SCD) is a life-long haematological disorder characterized by red blood cells that assume an abnormal, rigid, sickle shape and with high prevalence in West Africa. Sickle cell disease (SCD) is one of the most common genetic disorders among Africans as indicated in Akinyanju (1989). 61.4% of the children born annually with haemoglobinopathies worldwide have been reported to have SCD and they are from Africa as shown in World Health Organization Report (1987). Hypoxaemia is the hallmark of pulmonary abnormality in SCD patients of all age groups. This was first documented by Klinefelter (1942), and has since been corroborated by other workers. The hypoxaemia of stable SCD patients is said to result from the combined effects of perfusion and diffusion defect. Materials and Methods. This study was carried out to determine the changes in lung functions in relation to gender, age, and body mass index (BMI) of sickle-cell patients in a stable state. 60 subjects made up of 30 patients and 30 control groups were used in this study. Both test and control groups were 13 men and 17 women, aged 19-35 years. Lung Function Test was done with the aid of a digital spirometer (Spirolab II, Italy). Weight was measured using Avery scales (Avery Berkel, 2003, UK). Height was measured using a wall-mounted stadiometer. Data were collected and analyzed using Student's t-test and Pearson correlation. P < 0.05 was statistically significant. Results. The results revealed that adults with SCD had a significantly lower mean forced expiratory volume in one second (FEV 1 ) and forced vital capacity (FVC) compared to the control. The lung function indices were lower in females than males in the sickle cell patients. The FVC, FEV 1 , and FEV 1 /FVC correlated positively with BMI statistically in the patients. The lung function declined with age. This work has also shown that the most common pulmonary function test (PFT) abnormality was restrictive disease pattern (76.7%). Conclusion. The result of this work suggested that lung function differs significantly in subjects with SCD compared with matched controls of a similar age and gender.

Pulmonary function indices in children with sickle cell anemia in Enugu, south-east Nigeria

“…Most of the original studies are from western Nigeria. 13 , 14 This study could therefore corroborate or refute regional or ethnic differences in lung function in children with SCD. The study hypothesis seeks to answer the following questions?…”

“… 18 , 19 have alsoreported marginally, but not significantly higher values of lung function tests in healthy males compared with healthy females with HbAA genotype. 6 In the contrary, Oko-Ose et al 14 found significantly higher mean values of respiratory function tests in females compared with the males. The higher values of weight and body surface areas in females explained the gender variations.…”

Surfactant protein D as a marker for pulmonary complications in pediatric patients with sickle cell disease: Relation to lung function tests

“…The observed impaired ventilatory functions were explained by the reduction of lung compliance which may be due to repeated episodes of ACS or sickle‐cell‐related vasculopathy . Similar to our results, Oko‐Ose et al showed that the most common PFTs abnormality in adults with SCD was restrictive disease pattern (76.7%) and that OLD was relatively uncommon (23.3%). Moreover, Alameri et al found that nearly half (51%) of adults Saudi with SCD had abnormal PFTs; 36% of them had a restrictive pattern.…”

“…All patients performed spirometry using JAEGER apparatus (Hoechberg, Germany) to measure the following parameters: forced vital capacity (FVC), forced expiratory volume in first second (FEV 1 ), ratio between FEV1 and FVC (FEV 1 /FVC%) and forced expiratory flow rate during 25‐75% of expiration (FEF25‐75%). Standard methodology for acceptability of spirometry was followed as described by previous studies . Patients were excluded if the effort was not technically acceptable; if they were younger than 10 years of age and exhaled for less than 3 s or if they were older than 10 years of age and exhaled for less than 6 s.…”

“…During steady‐state SCD, the major abnormality in pulmonary function tests (PFTs) is restrictive ventilatory impairment, characterized by a mild reduction in total lung capacity and reduced diffusion capacity for carbon monoxide. In contrast to adults with SCD who showed a restrictive pattern, PFTs in children with SCD have shown conflicting evidences ranging from normal, obstructive and restrictive pattern …”