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Surfactant protein D as a marker for pulmonary complications in pediatric patients with sickle cell disease: Relation to lung function tests
Author(s) -
Tantawy Azza A.,
Adly Amira A.,
Ebeid Fatma S. E.,
Ismail Eman A.,
Hussein Mahitab M.,
Shaarawy Randa M.,
Kamel Reham A.
Publication year - 2019
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.24257
Subject(s) - medicine , pulmonary function testing , vital capacity , gastroenterology , biomarker , lung , acute chest syndrome , interstitial lung disease , restrictive lung disease , diffusing capacity , anemia , sickle cell anemia , lung volumes , cardiology , disease , lung function , biochemistry , chemistry
Background Surfactant protein D (SP‐D) is considered a candidate biomarker for lung integrity and for disease progression. Aim We determined the level of SP‐D in children and adolescents with SCD and assessed its possible relation to pulmonary complications and lung function. Methods Serum SP‐D levels were assessed in 50 SCD patients compared with 30 healthy controls. High‐resolution computerized tomography (HRCT) of the chest was done. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV 1 ), FEV 1 /FVC% and forced expiratory flow rate during 25‐75% of expiration (FEF25‐75%) were determined. Results SP‐D was significantly higher in SCD patients than controls, particularly patients with sickle cell anemia than those with sickle β‐thalassemia. SP‐D levels were significantly associated with increasing severity of interstitial lung disease. The highest SP‐D levels were observed among patients with restrictive lung disease followed by mixed type then obstructive lung disease. SP‐D was positively correlated to HbS and serum ferritin while negatively correlated to duration of hydroxyurea treatment and parameters of pulmonary functions. ROC curve analysis revealed that SP‐D cutoff value 720 ng/mL could significantly detect the presence of abnormal pulmonary function among SCD patients with 82% sensitivity and 88% specificity. Logistic regression analysis showed that SP‐D is an independent factor related to abnormal pulmonary function in SCD. Conclusions SP‐D may be a promising biomarker for screening of SCD patients for risk of later pulmonary complications.