{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T06:15:54Z","timestamp":1788243354194,"version":"build-2803163510"},"reference-count":34,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background: Asthma is an important respiratory comorbidity in children with sickle cell disease (SCD), but respiratory symptoms overlap with SCD-related pulmonary manifestations. Methods: We analyzed prospectively recorded routine-care data from 140 children aged 5\u201317 years who were offered a standardized respiratory assessment during clinically stable follow-up. During revision, we applied a post hoc operational spirometric comparator: reversible airflow obstruction required FEV1\/FVC &lt; 80% plus an FEV1 increase \u226512% after salbutamol. Participants with normal spirometry formed the negative comparator; incomplete or intermediate objective patterns remained unclassified. Results: Reversible obstruction was identified in 43 children, normal spirometry in 25, and 72 remained unclassified. Previous clinical suspicion was present in 10\/43 (23.3%), 3\/25 (12.0%), and 22\/72 (30.6%), respectively. In the deliberately contrastive classified-only analysis (n = 68), sensitivity was 23.3% (95% CI 11.8\u201338.6), specificity 88.0% (68.8\u201397.5), LR+ 1.94 (0.59\u20136.39), LR\u2212 0.87 (0.70\u20131.09), and \u03ba = 0.090 (95% CI \u22120.059 to 0.239). The likelihood-ratio intervals were wide and included 1.0, indicating substantial imprecision rather than proof of no discrimination. Conclusions: Prior clinical suspicion showed low sensitivity and slight agreement with spirometry-defined reversible obstruction. Interpretation is limited by the post hoc two-gate comparison and by the large, non-randomly distributed unclassified group.<\/jats:p>","DOI":"10.3390\/jcm15166342","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:01:26Z","timestamp":1786968086000},"page":"6342","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Discordance Between Clinical Suspicion and Spirometry-Defined Reversible Airflow Obstruction in Children with Sickle Cell Disease in French Guiana"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5406-3189","authenticated-orcid":false,"given":"Gabriel","family":"Bafunyembaka","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University Hospital of Guiana, Saint-Laurent-du-Maroni Site, 1465 Boulevard de la Libert\u00e9, Saint-Laurent-du-Maroni 97320, French Guiana"},{"name":"Department of Pediatrics, General Reference Hospital of Bukavu, Avenue Michombero, Bukavu, South Kivu, Democratic Republic of the Congo"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"}]},{"given":"Estiverne","family":"Evens","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University Hospital of Guiana, Saint-Laurent-du-Maroni Site, 1465 Boulevard de la Libert\u00e9, Saint-Laurent-du-Maroni 97320, French Guiana"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5149-7975","authenticated-orcid":false,"given":"Nadia","family":"Nathan","sequence":"additional","affiliation":[{"name":"Pediatric Pulmonology Department, Armand Trousseau Hospital, Assistance Publique\u2014H\u00f4pitaux de Paris, Sorbonne Universit\u00e9, 26 Avenue du Dr Arnold Netter, 75012 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"visualization","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9651-437X","authenticated-orcid":false,"given":"Arriel","family":"Makembi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Hospital of Guiana, Saint-Laurent-du-Maroni Site, 1465 Boulevard de la Libert\u00e9, Saint-Laurent-du-Maroni 97320, French Guiana"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0624-4180","authenticated-orcid":false,"given":"Narcisse","family":"Elenga","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Cayenne Hospital, 3 Avenue Alexis Blaise, Cayenne 97300, French Guiana"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"supervision","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"ref_1","unstructured":"GBD 2021 Sickle Cell Disease Collaborators (2023). Global, regional, and national prevalence and mortality burden of sickle cell disease, 2000\u20132021: A systematic analysis from the Global Burden of Disease Study 2021. Lancet Haematol., 10, e585\u2013e599."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e633","DOI":"10.1016\/S2352-3026(23)00096-0","article-title":"Defining global strategies to improve outcomes in sickle cell disease: A Lancet Haematology Commission","volume":"10","author":"Piel","year":"2023","journal-title":"Lancet Haematol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"240005","DOI":"10.1183\/16000617.0005-2024","article-title":"Respiratory management of acute chest syndrome in children with sickle cell disease","volume":"33","author":"Ahmed","year":"2024","journal-title":"Eur. Respir. Rev."},{"key":"ref_4","first-page":"35","article-title":"Patients with sickle cell disease and asthma have a higher risk for acute chest syndrome: A systematic review and meta-analysis of observational studies","volume":"31","author":"Dodos","year":"2026","journal-title":"Exp. Ther. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1007\/s12098-025-05749-7","article-title":"Association of asthma with acute vaso-occlusive crisis among French Guianese children with sickle cell disease","volume":"93","author":"Bafunyembaka","year":"2026","journal-title":"Indian J. Pediatr."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e001277","DOI":"10.1136\/bmjpo-2021-001277","article-title":"Diagnosis and management of asthma in children","volume":"6","author":"Martin","year":"2022","journal-title":"BMJ Paediatr. Open"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"00348","DOI":"10.1183\/23120541.00348-2019","article-title":"Defining asthma in children: How well do parents, doctors and spirometry agree?","volume":"6","author":"Korsten","year":"2020","journal-title":"ERJ Open Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2004173","DOI":"10.1183\/13993003.04173-2020","article-title":"European Respiratory Society clinical practice guidelines for the diagnosis of asthma in children aged 5\u201316 years","volume":"58","author":"Gaillard","year":"2021","journal-title":"Eur. Respir. J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"230048","DOI":"10.1183\/20734735.0048-2023","article-title":"Routine FEV1 measurement is essential in diagnosis and monitoring of childhood asthma: Myth or maxim?","volume":"19","author":"Onisor","year":"2023","journal-title":"Breathe"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.1111\/apa.16216","article-title":"Objective confirmation of asthma diagnosis, treatment adherence and patient outcomes in children and adolescents","volume":"111","author":"Aarestrup","year":"2022","journal-title":"Acta Paediatr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2101499","DOI":"10.1183\/13993003.01499-2021","article-title":"ERS\/ATS technical standard on interpretive strategies for routine lung function tests","volume":"60","author":"Stanojevic","year":"2022","journal-title":"Eur. Respir. J."},{"key":"ref_12","first-page":"100898","article-title":"Updated guidelines (2021) for management and follow-up of asthmatic patients of the French Society of Pneumology and the French Society of Pediatric Pneumology and Allergology: Short version","volume":"81","author":"Guilleminault","year":"2022","journal-title":"Respir. Med. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1080\/02770903.2020.1729381","article-title":"Validation of the Breathmobile Case Identification Survey for asthma screening in children with sickle cell disease","volume":"58","author":"Patel","year":"2021","journal-title":"J. Asthma"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1787","DOI":"10.1080\/02770903.2023.2187305","article-title":"Screening for asthma in preschool children with sickle cell disease","volume":"60","author":"Chan","year":"2023","journal-title":"J. Asthma"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1002\/ppul.25845","article-title":"Benefit of pulmonary subspecialty care for children with sickle cell disease and asthma","volume":"57","author":"Saxena","year":"2022","journal-title":"Pediatr. Pulmonol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Ozhan, A.K., Arikoglu, T., Er, M., Unal, S., Y\u0131ld\u0131r\u0131m, D.D., Erkasar, F., Balc\u0131, \u015e., Tamer, L., and Kuyucu, S. (2024). Lower arginine bioavailability, increased FeNO levels, and airway resistance on impulse oscillometry are characteristics of asthma in children and young adults with sickle cell disease. Medicina, 60.","DOI":"10.3390\/medicina60030446"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"De, A., Williams, S., Yao, Y., Jin, Z., Brittenham, G.M., Kattan, M., Lovinsky-Desir, S., and Lee, M.T. (2023). Acute chest syndrome, airway inflammation and lung function in sickle cell disease. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0283349"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2055","DOI":"10.1002\/ppul.24871","article-title":"Pulmonary functions in children and adolescents with sickle cell disease","volume":"55","author":"Bediwy","year":"2020","journal-title":"Pediatr. Pulmonol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Rein, A., Ngo, C., van den Berg, M., B\u00f6ll, S., Lassay, L., Kontny, U., Wagner, N., Leonhardt, S., Tenbrock, K., and Verjans, E. (2023). Evaluation of lung function in a German single-center cohort of young patients with sickle cell disease using electrical impedance tomography and standard techniques. Front. Med., 10.","DOI":"10.3389\/fmed.2023.1100180"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2047","DOI":"10.1002\/ppul.26995","article-title":"Deterioration of lung diffusion capacity during childhood in sickle cell disease","volume":"59","author":"Bokov","year":"2024","journal-title":"Pediatr. Pulmonol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"3419","DOI":"10.1002\/ppul.27222","article-title":"PM2.5 exposure and household income are associated with lung function abnormalities in children with sickle cell disease","volume":"59","author":"Kelchtermans","year":"2024","journal-title":"Pediatr. Pulmonol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"107564","DOI":"10.1016\/j.rmed.2024.107564","article-title":"The influence of body mass index on airway resistance in children with sickle cell disease: A longitudinal study based on impulse oscillometry","volume":"224","author":"Mondal","year":"2024","journal-title":"Respir. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1097\/ACI.0000000000000815","article-title":"Pulmonary function testing for the diagnosis of asthma in preschool children","volume":"22","author":"Chawes","year":"2022","journal-title":"Curr. Opin. Allergy Clin. Immunol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1002\/ppul.26728","article-title":"Comparison of bronchodilator responsiveness in asthmatic children using 2021 or 2005 ATS\/ERS guidelines","volume":"59","author":"Beydon","year":"2024","journal-title":"Pediatr. Pulmonol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e661","DOI":"10.1097\/MPH.0000000000002164","article-title":"Validation of a questionnaire to identify respiratory tract infections in children with sickle cell disease","volume":"43","author":"De","year":"2021","journal-title":"J. Pediatr. Hematol. Oncol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1080\/03630269.2020.1814321","article-title":"How I treat acute chest syndrome in asthmatic children with sickle cell disease: A practical review","volume":"44","author":"Almon","year":"2020","journal-title":"Hemoglobin"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1080\/17474086.2022.2085089","article-title":"Management of acute chest syndrome in patients with sickle cell disease: A systematic review of randomized clinical trials","volume":"15","author":"Niazi","year":"2022","journal-title":"Expert Rev. Hematol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1914","DOI":"10.3324\/haematol.2021.280105","article-title":"Effects of corticosteroids in patients with sickle cell disease and acute complications: A systematic review and meta-analysis","volume":"107","author":"Lopinto","year":"2022","journal-title":"Haematologica"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1080\/02770903.2022.2070762","article-title":"Factors associated with future hospitalization among children with asthma: A systematic review","volume":"60","author":"Aggarwal","year":"2023","journal-title":"J. Asthma"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.1002\/ppul.26342","article-title":"Validity of the Childhood Asthma Control Test in diverse populations: A systematic review","volume":"58","author":"Chu","year":"2023","journal-title":"Pediatr. Pulmonol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1002\/ppul.26300","article-title":"Functional capacity and quality of life in children and adolescents with sickle cell anemia","volume":"58","author":"Soares","year":"2023","journal-title":"Pediatr. Pulmonol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e28672","DOI":"10.1002\/pbc.28672","article-title":"Feasibility and preliminary outcomes of an integrated pediatric sickle cell disease and pulmonary care clinic for children with sickle cell disease","volume":"67","author":"Black","year":"2020","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e71147","DOI":"10.1002\/ppul.71147","article-title":"Use of asthma medications in African American children with sickle cell disease: A single-center experience","volume":"60","author":"Jue","year":"2025","journal-title":"Pediatr. Pulmonol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1542\/pir.2024-006659","article-title":"Breathing easier: Optimizing pulmonary health in children with sickle cell disease","volume":"46","author":"Kuntzman","year":"2025","journal-title":"Pediatr. Rev."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/16\/6342\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T05:51:25Z","timestamp":1788241885000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/16\/6342"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,17]]},"references-count":34,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["jcm15166342"],"URL":"https:\/\/doi.org\/10.3390\/jcm15166342","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,17]]}}}