Acute Chest Syndrome (ACS)

The blood film shows sickle cells (green arrow) whilst the chest X-ray has pulmonary infiltrates (white arrow). 

Assuming the infiltrates are new, the respiratory symptoms point towards Acute Chest Syndrome (ACS).

The factors leading to this include: 

• Vascular sickling in the lung causing infarction 
• Infection
• Fat embolism 

Mortality can be as high as 10% in adults! Respiratory support (oxygen, invasive/non-invasive ventilation), treatment of infection is needed. 

Reducing the HbS% can be done using exchange transfusion or simple transfusion. Remember to act quickly, time is precious to prevent further complications. 

Our intensive colleagues are so important in all these patients (keep them happy).

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