A Pediatric Patient with Idiopathic Short Stature Who Developed Obstructive Sleep Apnea after Starting Growth Hormone Replacement Therapy.

Publication/Presentation Date

1-1-2017

Abstract

Background: Growth hormone (GH) therapy has long been suspected to induce obstructive sleep apnea (OSA) in children and adults. Moreover, reports about GH-associated sudden death in children with Prader-Willi syndrome (PWS) have prompted concerns about GH worsening sleep apnea. Previous studies have supported routine polysomnography for children with PWS prior to starting GH treatments, regardless of clinical history. However, there are no established guidelines recommending routine polysomnography (PSG) prior to the commencement of GH therapy in other pediatric patients.

Case description: We report a case of a 15-year-old young man with intractable headaches, referred to the sleep clinic to rule out any sleep-related variables. After an initial non-significant (mild snoring) sleep study, the patient returned with worsening snoring about one year after starting GH therapy for concerns of short stature.

Results: A second polysomnogram revealed that his obstructive apnea-hypopnea index had risen dramatically from baseline. His symptoms resolved after tonsillectomy and adenoidectomy.

Conclusion: This interesting case highlights the need for caution with any patient eligible for GH therapy. We recommend additional research to look in the development of definitive guidelines regarding the indications for polysomnography for patients with idiopathic short stature and non-significant initial sleep history-particularly before and during the administration of GH therapy.

Volume

11

Issue

4

ISSN

1747-0862

Disciplines

Medicine and Health Sciences | Pediatrics

PubMedID

29399036

Department(s)

Department of Pediatrics, Department of Pediatrics Faculty, Department of Pediatrics Residents

Document Type

Article

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