Urinary cysteinyl leukotriene e ₄ is associated with increased risk for pain and acute chest syndrome in adults with sickle cell disease

Leukotriene E ₄ (LTE ₄) levels are associated with rate of pain episodes in children with sickle cell disease (SCD). Because complications of SCD manifest differently in adults than children, we examined a cohort of adults with SCD to determine the relationship between baseline LTE ₄ and SCD-related morbidity. Baseline LTE ₄ levels were associated with increased rates of pain and acute chest syndrome (ACS) episodes, when those with LTE ₄ values in the highest tertile were compared with those in the lowest tertile (pain: risk ratio 7.1, 95% CI 1.8-27.5, P = 0.005; ACS: risk ratio 12.2, 95% CI 2.1-69.8, P = 0.005).