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Acute chest syndrome and sickle cell disease


What is acute chest syndrome?

Acute chest syndrome (ACS) is a complication (health problem) caused by sickle cell disease. It is unique to sickle cell disease (SCD). It is “pneumonia” or a new “infiltrate” (seen as a white shadow on a chest X-ray) along with one (1) or more of the following symptoms:

  • Chest pain (back or stomach pain may also be a symptom)
  • Trouble breathing
  • Fever (temperature of 100.4 degrees F [38o C] or higher)
  • Fast breathing
  • Coughing, wheezing, shortness of breath

What causes acute chest syndrome?

Sickle red blood cells can block the blood vessels in the lungs. This reduces oxygen flow to the lungs and can make it hard to breathe. This condition is an emergency and may be life-threatening. Your child will need hospital treatment for ACS. 

If your child is having symptoms of ACS, follow these guidelines.

Monday–Friday from 7:30 a.m. to 5 p.m. (excluding holidays), call the clinic at 901-595-5041.

After 5 p.m. and on weekends and holidays:

Call the St. Jude operator at 901-595-3300 and ask to speak with the hematologist on call. If there is a delay in speaking with someone from St. Jude, you should seek care at your local hospital emergency department.

What is the treatment for acute chest syndrome?

Your child will be admitted to the hospital, and the staff will need to take vital signs every 4 hours. Your child will also have a chest X-ray and be treated with IV fluids and antibiotics. Your child might need a red blood cell transfusion and oxygen. While in the hospital, the nurses and doctors will encourage your child to get out of bed and walk to help the lungs recover. Your child will be asked to blow into an incentive spirometer, a device that helps open the air sacs in the lungs. 

Can my child get acute chest syndrome more than one time?

Yes. Children with sickle cell disease are at risk for repeat episodes of ACS. If your child has asthma or any other type of lung problems, there is an even greater risk for ACS. Viral illnesses can progress to acute chest syndrome. Be sure to vaccinate your child against influenza (the flu).


If you have questions about ACS, talk to members of your child’s St. Jude Hematology team. 


This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your physician.

St. Jude complies with health care-related federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

ATTENTION: If you speak another language, assistance services, free of charge, are available to you. Call 1-866-278-5833 (TTY: 1-901-595-1040).

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-278-5833 (TTY: 1-901-595-1040).

تنبيه: إذا كنت تتحدث باللغة العربية فيمكنك الاستعانة بخدمات المساعدة اللغوية المتوفرة لك مجانا. .يرجى الاتصال بالرقم. 5833-278-866-1  (الهاتف النصي: 1040-595-901-1).