RT Journal Article SR Electronic T1 Golden Tracheal Secretions and Bronchoalveolar Fluid During Acute Chest Syndrome in Sickle Cell Disease JF Respiratory Care FD American Association for Respiratory Care SP respcare.03517 DO 10.4187/respcare.03517 A1 Contou, Damien A1 Mekontso Dessap, Armand A1 Carteaux, Guillaume A1 Brun-Buisson, Christian A1 Maitre, Bernard A1 de Prost, Nicolas YR 2014 UL http://rc.rcjournal.com/content/early/2014/10/17/respcare.03517.abstract 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.