ESPE Abstracts (2016) 86 P-P2-542

Instituto da Criança do Hospital das Clinicas da Faculdade de Medicina da USP, Sao Paulo/SP, Brazil

Background: Obstructive sleep apnea syndrome (OSAS) in children is a common medical disorder, often associated with adenoid and tonsil hypertrophy. The prevalence of OSAS has been increasing due to alarming rates of obesity in childhood. This is a very concerning subject since there is a higher risk of cardiovascular outcomes in patients with elevated BMI and OSAS.

Objective and hypotheses: The aim of this study is to report a hazardous case regarding childhood obesity and its association with OSAS.

Resumed report: Two and half years-old girl followed in the pediatric endocrinology clinic, due to obesity (weight: 38 kg (Z=+7.63) and BMI: 39.5 kg/m2 (Z=+8.57)), and other complications, such as: high blood pressure with microalbuminuria, retinopathy with arteriolar narrowing, insulin resistance, dyslipidemia, moderate concentric hypertrophy of the left ventricle and hepatic steatosis. She had lethargy and daytime somnolence, snoring and night apnea, needing emergency care in one of the apnea episodes. An overnight polysomnography was requested, revealing an apnea-hypopnea index of 23.9/hour, and an oxygen-desaturation average 81.9%. The diagnosis of severe OSAS was made, and adenotonsillectomy indicated, but due to no clinical conditions to a surgery procedure, ventilator support (BIPAP) and weight loss were proposed. Polysomnography under BIPAP use was normalized and patient evolved with clinical and life quality improvement.

Conclusion: Even in early childhood obesity could be associated with severe apnea. A precocious diagnose and approach could change life quality and prevent sudden death risk.

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