• lung physiology
• paediatric lung disease
• respiratory measurement
• systemic disease and lungs

Sickle cell disease (SCD) affects 300 000 children born worldwide annually. While classically thought of as a genetic haemoglobinopathy, complications impact nearly every vascular bed leading to progressive organ damage and accelerated mortality. Pulmonary complications of SCD are among the most common causes of morbidity and mortality and affect every structure of the lungs. Abnormal pulmonary function is often one of the earliest indicators of lung disease, yet our understanding of the clinical significance of this finding is poor. 

Prior studies suggest several consistent themes: (1) while most children with SCD have lung function within the normal range,1 2 spirometry is, on average, reduced compared with healthy …