Therapeutic Anticoagulation for Acute Chest Syndrome in Sickle Cell Disease

Sickle cell disease predisposes patients to hypercoagulability, and pulmonary microthrombosis can contribute to acute chest syndrome even if no macroscopic clots are detected. If this is true, could therapeutic anticoagulation alleviate microthrombosis, leading to quicker relief for patients? To find out, French researchers randomized 172 adults with sickle cell disease (mean age, 30) complicated by acute chest syndrome to receive therapeutic or prophylactic anticoagulation with tinzaparin, a low-molecular-weight heparin. The investigators excluded patients with macroscopic pulmonary emboli found on imaging and administered standard treatments for acute chest syndrome (e.g., pain control, antibiotics, incentive spirometry).

The researchers n…