PT  - JOURNAL ARTICLE
AU  - Contou, Damien
AU  - Mekontso Dessap, Armand
AU  - Carteaux, Guillaume
AU  - Brun-Buisson, Christian
AU  - Maitre, Bernard
AU  - de Prost, Nicolas
TI  - Golden Tracheal Secretions and Bronchoalveolar Fluid During Acute Chest Syndrome in Sickle Cell Disease
AID  - 10.4187/respcare.03517
DP  - 2014 Oct 14
TA  - Respiratory Care
PG  - respcare.03517
4099  - http://rc.rcjournal.com/content/early/2014/10/17/respcare.03517.short
4100  - http://rc.rcjournal.com/content/early/2014/10/17/respcare.03517.full
AB  - Acute chest syndrome (ACS) is the leading cause of ICU admission in patients with sickle cell disease and is characterized by golden sputum, which is commonly attributed to the presence of bilirubin. Three young consecutive patients with homozygous sickle cell disease were admitted for severe acute respiratory syndrome due to ACS. In all 3 patients, tracheal secretions and bronchoalveolar lavage fluid (BALF) showed a yellowish plasma-like stain. After normalization for the plasma-to-BAL urea ratio, BALF protein and lactate dehydrogenase levels were consistent with an exudative process. BALF bilirubin concentrations were very low, implying that the yellowish stain was not related to bilirubin content. The yellowish coloration of tracheal secretions and BALF observed during ACS appears to be related to an intense exudative process rather than to the presence of bilirubin.