Abstract
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.
- sickle cell disease
- acute chest syndrome
- yellow sputum
- acute respiratory distress syndrome
- pulmonary fat embolism
- intensive care
Footnotes
- Correspondence: Nicolas de Prost MD PhD, Service de Réanimation Médicale, Groupe Henri Mondor-Albert Chenevier, Assistance Publique Hôpitaux de Paris, 51 avenue du Maréchal de Lattre de Tassigny, 94010 Créteil Cedex, France. E-mail: nicolas.de-prost{at}hmn.aphp.fr.
The authors have disclosed no conflicts of interest.
- Copyright © 2014 by Daedalus Enterprises Inc.
