Sir.—Recently we treated a 12-year-old boy with sickle cell anemia and acute chest syndrome (ACS) who had decreased air entry in the same way an asthmatic patient does. This prompted us to treat him with nebulized albuterol, which improved his dyspnea and aeration. Finding no reports of β2 agonist use in acute chest syndrome we performed the following preliminary study to determine if albuterol inhalation therapy could be a useful adjunct in the treatment of ACS in sickle cell anemia.
Patient Reports.—Four patients, including the aforementioned one, all with ACS and sickle cell anemia, were evaluated. None had a personal or family history of asthma or wheezing. Each was at least 8 years old, enabling use of the Wright peak flow meter. Initially each patient had chest pain, difficulty breathing, decreased breath sounds and/or crackles on chest auscultation, and roentgenographic evidence of an acute pulmonary infiltrate. Each was