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Acute
chest syndrome may not have an atherosclerotic
background in sickle cell diseases
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Mehmet Rami Helvaci (1)
Hasan Yilmaz (2)
Atilla Yalcin (1)
Orhan Ekrem Muftuoglu (1)
Abdulrazak Abyad (3)
Lesley Pocock (4)
(1) Specialist of Internal Medicine,
MD
(2) Specialist of Ear, Nose, and Throat Diseases,
MD
(3) Middle-East Academy for Medicine of Aging,
MD
(4) medi-WORLD International
Corresponding author:
Prof Dr Mehmet Rami Helvaci,
07400, ALANYA, Turkey
Phone: 00-90-506-4708759
Email: mramihelvaci@hotmail.com
Received July 2021. Accepted
August 2021. Published September 1, 2021.Please
cite this article as: Helvaci MR et al. Acute
chest syndrome may not have an atherosclerotic
background in sickle cell diseases. Middle East
J Intern Med 2021; 14(2): 10- 19. DOI: 10.5742/MEJIM2020.93797.
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ABSTRACT
Background:
We tried to understand whether or not there
is a significant relationship between acute chest
syndrome (ACS) and atherosclerosis in sickle cell
diseases (SCD).
Methods: All patients
with the SCD were included.
Results: The study included
434 patients (222 males) with similar mean ages
in male and female genders (30.8 versus 30.3 years,
respectively, p>0.05). Smoking (23.8% versus
6.1%, p<0.001) and alcohol (4.9% versus 0.4%,
p<0.001) were higher in males, significantly.
Transfused units of red blood cells (RBC) in their
lives (48.1 versus 28.5, p=0.000) were also higher
in males, significantly. Similarly, disseminated
teeth losses (<20 teeth present) (5.4% versus
1.4%, p<0.001), chronic obstructive pulmonary
disease (COPD) (25.2% versus 7.0%, p<0.001),
ileus (7.2% versus 1.4%, p<0.001), cirrhosis
(8.1% versus 1.8%, p<0.001), leg ulcers (19.8%
versus 7.0%, p<0.001), digital clubbing (14.8%
versus 6.6%, p<0.001), coronary heart disease
(CHD) (18.0% versus 13.2%, p<0.05), chronic
renal disease (CRD) (9.9% versus 6.1%, p<0.05),
and stroke (12.1% versus 7.5%, p<0.05) were
all higher in males but not ACS (2.7% versus 3.7%,
p>0.05) in the SCD.
Conclusion: SCD are severe
inflammatory processes on vascular endothelium,
particularly at the capillary level since the
capillary system is the main distributor of hardened
RBC into the tissues. Although the higher smoking
and alcohol-like strong atherosclerotic risk factors
and disseminated teeth losses, COPD, ileus, cirrhosis,
leg ulcers, digital clubbing, CHD, CRD, and stroke-like
obvious atherosclerotic consequences in male gender,
ACS was not higher in them, significantly. In
another definition, ACS may not have an atherosclerotic
background in the SCD.
Key words: Sickle cell
diseases, chronic endothelial damage, atherosclerosis,
acute chest syndrome, male gender, smoking, alcohol
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