How Prevalent Is Pulmonary Thrombosis During Acute Chest Syndrome?

Acute chest syndrome (ACS), characterized by dyspnea, chest pain, and opacities on chest radiograph, is a poorly understood complication of sickle cell disease, and its pathology is thought to result from microvascular occlusion as well as fat embolization. French researchers assessed the incidence of macrovascular pulmonary artery thrombosis –– previously ill-defined –– in this setting.

One hundred three patients who suffered 121 ACS episodes underwent multidetector computed tomography (MDCT). Seventeen percent of studies were positive for thrombosis, and most (75%) involved segmental clots. Interestingly, all patients with positive MDCT scans also underwent Doppler ultrasound of the lower extremities, and none of these tests were positive.…