Document Detail


Longitudinal association between growth hormone therapy and obstructive sleep apnea in a child with Prader-Willi syndrome.
MedLine Citation:
PMID:  20943780     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
CONTEXT: Descriptions of the development of symptoms of upper airway obstruction and sudden death of children with Prader-Willi Syndrome (PWS) while on GH therapy have led to concern about GH contributing to obstructive sleep apnea (OSA), especially early in treatment. However, two studies using monitoring with polysomnography (PSG) have not shown deterioration in OSA after 6 wk on GH, except as related to upper respiratory tract infections.
OBJECTIVE: The aim was to describe the evolution of OSA in a girl with PWS on GH treatment in order to highlight important aspects of long-term clinical monitoring for patients with PWS on GH treatment. PATIENT AND RESEARCH DESIGN: GH was commenced when the patient was 2.9 yr of age. PSG was performed at baseline and 7 wk after commencing GH, plus at intervals throughout treatment based on symptoms of OSA. Intervention: GH was given at doses ranging from 4.2 to 4.7 mg/m(2) · wk over a period of 3 yr.
MAIN OUTCOME MEASURE: OSA was quantified by PSG.
RESULTS: OSA was not present at baseline or after 7 wk on GH but developed after 6 months, following a small increase in GH dose. Cessation of GH was accompanied by resolution of OSA. GH was restarted 2 yr later, again associated with the development of OSA that resolved after cessation of GH.
CONCLUSION: This case highlights that OSA may develop late in GH treatment. Children should be monitored for the symptoms of OSA throughout GH treatment, and PSG should be repeated if symptoms develop.
Authors:
Gillian M Nixon; Christine P Rodda; Margot J Davey
Publication Detail:
Type:  Journal Article     Date:  2010-10-13
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  96     ISSN:  1945-7197     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  29-33     Citation Subset:  AIM; IM    
Affiliation:
Melbourne Children's Sleep Centre, Department of Respiratory and Sleep Medicine, Monash Medical Centre, Melbourne, Victoria, Australia. gillian.nixon@southernhealth.org.au
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