Clinical Presentation and Diagnosis of ACS in SCD General

• Occurs in 15% to 43% of patients and is responsible for 25% of deaths

• Risk factors include young age, low HbF level, high Hgb and WBCs, winter seasons, reactive airway disease

• Recurrences are up to 80% and can lead to chronic lung disease Symptoms

• Patients may complain of cough, fever, dyspnea, chest pain Signs

• New infiltrate on chest x-ray Laboratory Tests

• Complete blood count with reticulocyte

• Oxygen saturation

• Cultures (blood and sputum) Other

• Closely monitor pulmonary status

The use of corticosteroids is controversial. While they may decrease the inflammation and endothelial cell adhesion seen with ACS, their use has also been associated with higher readmission rates for other complications. Tapered corticosteroids, nitric

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oxide therapy, and l-arginine are being evaluated for use in ACS in studies.

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