Upper airway lymphoid tissue size in children with sickle cell disease

Temima Strauss, Sanghun Sin, Carole L. Marcus, Thornton B A Mason, Joseph M. McDonough, Julian L. Allen, Jason B. Caboot, Cheryl Y. Bowdre, Abbas F. Jawad, Kim Smith-Whitley, Kwaku Ohene-Frempong, Allan I. Pack, Raanan Arens

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Background: The prevalence of obstructive sleep apnea syndrome (OSAS) is higher in children with sickle cell disease (SCD) as compared with the general pediatric population. It has been speculated that overgrowth of the adenoid and tonsils is an important contributor. Methods: The current study used MRI to evaluate such an association. We studied 36 subjects with SCD (aged 6.9 ± 4.3 years) and 36 control subjects (aged 6.6 ± 3.4 years). Results: Compared with control subjects, children with SCD had a significantly smaller upper airway (2.8 ± 1.2 cm 3 vs 3.7 ± 1.6 cm 3, P<.01), and significantly larger adenoid (8.4 ± 4.1 cm 3 vs 6.0 ± 2.2 cm 3, P<.01), tonsils (7.0 ± 4.3 cm 3 vs 5.1 ± 1.9 cm 3, P<.01), retropharyngeal nodes (3.0 ± 1.9 cm 3 vs 2.2 ± 0.9 cm 3, P<.05), and deep cervical nodes (15.7 ± 5.7 cm 3 vs 12.7 ± 4.0 cm 3, P<.05). Polysomnography showed that 19.4% (seven of 36) of children with SCD had OSAS compared with 0% (zero of 20) of control subjects (P<.05) and that in children with SCD the apnea-hypopnea index correlated positively with upper airway lymphoid tissues size (r = 0.57, P< 001). In addition, children with SCD had lower arterial oxygen saturation nadir (84.3% ± 12.3% vs 91.2% ± 4.2%, P<.05), increased peak end-tidal CO 2 (53.4 ± 8.5 mm Hg vs 42.3 ± 5.3 mm Hg, P<.001), and increased arousals (13.7 ± 4.7 events/h vs 10.8 ± 3.8 events/h, P<.05). Conclusions: Children with SCD have reduced upper airway size due to overgrowth of the surrounding lymphoid tissues, which may explain their predisposition to OSAS.

Original languageEnglish (US)
Pages (from-to)94-100
Number of pages7
JournalChest
Volume142
Issue number1
DOIs
StatePublished - Jul 2012

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Sickle Cell Anemia
Lymphoid Tissue
Obstructive Sleep Apnea
Adenoids
Palatine Tonsil
Polysomnography
Apnea
Carbon Monoxide
Arousal
Pediatrics
Oxygen
Population

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Strauss, T., Sin, S., Marcus, C. L., Mason, T. B. A., McDonough, J. M., Allen, J. L., ... Arens, R. (2012). Upper airway lymphoid tissue size in children with sickle cell disease. Chest, 142(1), 94-100. https://doi.org/10.1378/chest.11-2013

Upper airway lymphoid tissue size in children with sickle cell disease. / Strauss, Temima; Sin, Sanghun; Marcus, Carole L.; Mason, Thornton B A; McDonough, Joseph M.; Allen, Julian L.; Caboot, Jason B.; Bowdre, Cheryl Y.; Jawad, Abbas F.; Smith-Whitley, Kim; Ohene-Frempong, Kwaku; Pack, Allan I.; Arens, Raanan.

In: Chest, Vol. 142, No. 1, 07.2012, p. 94-100.

Research output: Contribution to journalArticle

Strauss, T, Sin, S, Marcus, CL, Mason, TBA, McDonough, JM, Allen, JL, Caboot, JB, Bowdre, CY, Jawad, AF, Smith-Whitley, K, Ohene-Frempong, K, Pack, AI & Arens, R 2012, 'Upper airway lymphoid tissue size in children with sickle cell disease', Chest, vol. 142, no. 1, pp. 94-100. https://doi.org/10.1378/chest.11-2013
Strauss T, Sin S, Marcus CL, Mason TBA, McDonough JM, Allen JL et al. Upper airway lymphoid tissue size in children with sickle cell disease. Chest. 2012 Jul;142(1):94-100. https://doi.org/10.1378/chest.11-2013
Strauss, Temima ; Sin, Sanghun ; Marcus, Carole L. ; Mason, Thornton B A ; McDonough, Joseph M. ; Allen, Julian L. ; Caboot, Jason B. ; Bowdre, Cheryl Y. ; Jawad, Abbas F. ; Smith-Whitley, Kim ; Ohene-Frempong, Kwaku ; Pack, Allan I. ; Arens, Raanan. / Upper airway lymphoid tissue size in children with sickle cell disease. In: Chest. 2012 ; Vol. 142, No. 1. pp. 94-100.
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abstract = "Background: The prevalence of obstructive sleep apnea syndrome (OSAS) is higher in children with sickle cell disease (SCD) as compared with the general pediatric population. It has been speculated that overgrowth of the adenoid and tonsils is an important contributor. Methods: The current study used MRI to evaluate such an association. We studied 36 subjects with SCD (aged 6.9 ± 4.3 years) and 36 control subjects (aged 6.6 ± 3.4 years). Results: Compared with control subjects, children with SCD had a significantly smaller upper airway (2.8 ± 1.2 cm 3 vs 3.7 ± 1.6 cm 3, P<.01), and significantly larger adenoid (8.4 ± 4.1 cm 3 vs 6.0 ± 2.2 cm 3, P<.01), tonsils (7.0 ± 4.3 cm 3 vs 5.1 ± 1.9 cm 3, P<.01), retropharyngeal nodes (3.0 ± 1.9 cm 3 vs 2.2 ± 0.9 cm 3, P<.05), and deep cervical nodes (15.7 ± 5.7 cm 3 vs 12.7 ± 4.0 cm 3, P<.05). Polysomnography showed that 19.4{\%} (seven of 36) of children with SCD had OSAS compared with 0{\%} (zero of 20) of control subjects (P<.05) and that in children with SCD the apnea-hypopnea index correlated positively with upper airway lymphoid tissues size (r = 0.57, P< 001). In addition, children with SCD had lower arterial oxygen saturation nadir (84.3{\%} ± 12.3{\%} vs 91.2{\%} ± 4.2{\%}, P<.05), increased peak end-tidal CO 2 (53.4 ± 8.5 mm Hg vs 42.3 ± 5.3 mm Hg, P<.001), and increased arousals (13.7 ± 4.7 events/h vs 10.8 ± 3.8 events/h, P<.05). Conclusions: Children with SCD have reduced upper airway size due to overgrowth of the surrounding lymphoid tissues, which may explain their predisposition to OSAS.",
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AU - Sin, Sanghun

AU - Marcus, Carole L.

AU - Mason, Thornton B A

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AU - Allen, Julian L.

AU - Caboot, Jason B.

AU - Bowdre, Cheryl Y.

AU - Jawad, Abbas F.

AU - Smith-Whitley, Kim

AU - Ohene-Frempong, Kwaku

AU - Pack, Allan I.

AU - Arens, Raanan

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N2 - Background: The prevalence of obstructive sleep apnea syndrome (OSAS) is higher in children with sickle cell disease (SCD) as compared with the general pediatric population. It has been speculated that overgrowth of the adenoid and tonsils is an important contributor. Methods: The current study used MRI to evaluate such an association. We studied 36 subjects with SCD (aged 6.9 ± 4.3 years) and 36 control subjects (aged 6.6 ± 3.4 years). Results: Compared with control subjects, children with SCD had a significantly smaller upper airway (2.8 ± 1.2 cm 3 vs 3.7 ± 1.6 cm 3, P<.01), and significantly larger adenoid (8.4 ± 4.1 cm 3 vs 6.0 ± 2.2 cm 3, P<.01), tonsils (7.0 ± 4.3 cm 3 vs 5.1 ± 1.9 cm 3, P<.01), retropharyngeal nodes (3.0 ± 1.9 cm 3 vs 2.2 ± 0.9 cm 3, P<.05), and deep cervical nodes (15.7 ± 5.7 cm 3 vs 12.7 ± 4.0 cm 3, P<.05). Polysomnography showed that 19.4% (seven of 36) of children with SCD had OSAS compared with 0% (zero of 20) of control subjects (P<.05) and that in children with SCD the apnea-hypopnea index correlated positively with upper airway lymphoid tissues size (r = 0.57, P< 001). In addition, children with SCD had lower arterial oxygen saturation nadir (84.3% ± 12.3% vs 91.2% ± 4.2%, P<.05), increased peak end-tidal CO 2 (53.4 ± 8.5 mm Hg vs 42.3 ± 5.3 mm Hg, P<.001), and increased arousals (13.7 ± 4.7 events/h vs 10.8 ± 3.8 events/h, P<.05). Conclusions: Children with SCD have reduced upper airway size due to overgrowth of the surrounding lymphoid tissues, which may explain their predisposition to OSAS.

AB - Background: The prevalence of obstructive sleep apnea syndrome (OSAS) is higher in children with sickle cell disease (SCD) as compared with the general pediatric population. It has been speculated that overgrowth of the adenoid and tonsils is an important contributor. Methods: The current study used MRI to evaluate such an association. We studied 36 subjects with SCD (aged 6.9 ± 4.3 years) and 36 control subjects (aged 6.6 ± 3.4 years). Results: Compared with control subjects, children with SCD had a significantly smaller upper airway (2.8 ± 1.2 cm 3 vs 3.7 ± 1.6 cm 3, P<.01), and significantly larger adenoid (8.4 ± 4.1 cm 3 vs 6.0 ± 2.2 cm 3, P<.01), tonsils (7.0 ± 4.3 cm 3 vs 5.1 ± 1.9 cm 3, P<.01), retropharyngeal nodes (3.0 ± 1.9 cm 3 vs 2.2 ± 0.9 cm 3, P<.05), and deep cervical nodes (15.7 ± 5.7 cm 3 vs 12.7 ± 4.0 cm 3, P<.05). Polysomnography showed that 19.4% (seven of 36) of children with SCD had OSAS compared with 0% (zero of 20) of control subjects (P<.05) and that in children with SCD the apnea-hypopnea index correlated positively with upper airway lymphoid tissues size (r = 0.57, P< 001). In addition, children with SCD had lower arterial oxygen saturation nadir (84.3% ± 12.3% vs 91.2% ± 4.2%, P<.05), increased peak end-tidal CO 2 (53.4 ± 8.5 mm Hg vs 42.3 ± 5.3 mm Hg, P<.001), and increased arousals (13.7 ± 4.7 events/h vs 10.8 ± 3.8 events/h, P<.05). Conclusions: Children with SCD have reduced upper airway size due to overgrowth of the surrounding lymphoid tissues, which may explain their predisposition to OSAS.

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