Tapered oral dexamethasone for the acute chest syndrome of sickle cell disease.

Abstract

Tapered oral dexamethasone for acute chest syndrome (ACS) in sickle cell anaemia was studied using a novel ACS assessment tool and investigational biomarkers. Twelve participants were randomized (mean age 17·3 years) before early study termination. Dexamethasone decreased duration of hospitalization for ACS by 20·8 h compared to placebo (P = 0·024). Rebound pain occurred in both groups (3 dexamethasone versus 1 placebo). Overall, dexamethasone decreased the leucocyte activation biomarker, sL-selectin; however, participants with rebound pain had higher sL-selectin within 24 h of treatment (dexamethasone or placebo). This ACS assessment tool was feasibly applied, and sL-selectin is a promising biomarker of ACS therapy.

• Authors: Charles T Quinn, Marie J Stuart, Karen Kesler, Kenneth I Ataga, Winfred C Wang, Lori Styles, Kim Smith-Whitley, Ted Wun, Ashok Raj, Lewis L Hsu, Suba Krishnan, Frans A Kuypers, Yamaja Setty, Seungshin Rhee, Nigel S Key, George R Buchanan, Investigators of the Comprehensive Sickle Cell Centers
• Journal: British journal of haematology (Br J Haematol) Vol. 155 Issue 2 Pg. 263-7 (Oct 2011) ISSN: 1365-2141 [Electronic] England
• PMID: 21848879 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, N.I.H., Extramural)
• Copyright: © 2011 Blackwell Publishing Ltd.

Chemical References

• Cell Adhesion Molecules
• Nitric Oxide
• Dexamethasone
• C-Reactive Protein

Topics

• Acute Chest Syndrome (blood, drug therapy, etiology, therapy)
• Adolescent
• Adult
• Anemia, Sickle Cell (complications)
• C-Reactive Protein (analysis)
• Cell Adhesion Molecules (blood)
• Child
• Child, Preschool
• Combined Modality Therapy
• Dexamethasone (administration & dosage, therapeutic use)
• Dose-Response Relationship, Drug
• Double-Blind Method
• Drug Administration Schedule
• Female
• Humans
• Male
• Middle Aged
• Nitric Oxide (blood)
• Oxygen Inhalation Therapy
• Sickle Cell Trait (complications)
• Treatment Outcome
• Young Adult
• beta-Thalassemia (complications)