TY - JOUR
T1 - Upper airway lymphoid tissue size in children with sickle cell disease
AU - Strauss, Temima
AU - Sin, Sanghun
AU - Marcus, Carole L.
AU - Mason, Thornton B.A.
AU - McDonough, Joseph M.
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
N1 - Funding Information:
Author contributions: Dr Arens had full access to the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Ms Strauss: contributed to performing research, contributed new analytical tools, analyzed data, and wrote the manuscript. Mr Sin: contributed to performing research, contributed new analytical tools, analyzed data, and wrote the manuscript. Dr Marcus: contributed to designing research, performed research, analyzed data, and wrote the manuscript. Dr Mason: contributed to designing research, performed research, analyzed data, and wrote the manuscript. Mr McDonough: contributed to designing research, analyzed data, and wrote the manuscript. Dr Allen: contributed to designing research, performed research, and wrote the manuscript. Dr Caboot: contributed to designing research, performed research, and analyzed data. Dr Bowdre: contributed to performing research and wrote the manuscript. Dr Jawad: contributed to designing research, analyzed data, and wrote the manuscript. Dr Smith-Whitley: contributed to designing research, performed research, and wrote the manuscript. Dr Ohene-Frempong: contributed to designing research, performed research, and wrote the manuscript. Dr Pack: contributed to designing research, contributed new analytical tools, and wrote the manuscript. Dr Arens: contributed to designing research, performed research, contributed new analytical tools, analyzed data, and wrote the manuscript. Financial/nonfinancial disclosures: The authors have reported to CHEST the following conflicts of interest: Dr Marcus has funding from Phillips Respironics (not related to the current project) and Dr Pack received an endowed chair from the Respironics Foundation (not related to the current project). Ms Strauss, Messrs Sin and McDonough, and Drs Mason, Allen, Caboot, Bowdre, Jawad, Smith-Whitley, Ohene-Frempong, and Arens have reported that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article. Role of sponsors: The sponsor had no role in the design of the study, the collection and analysis of the data, or in the preparation of the manuscript. Other contributions: This work was performed at the Children's Hospital of Philadelphia and Children's Hospital at Montefiore.
PY - 2012/7
Y1 - 2012/7
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 cm3 vs 3.7 ± 1.6 cm 3, P<.01), and significantly larger adenoid (8.4 ± 4.1 cm3 vs 6.0 ± 2.2 cm3, P<.01), tonsils (7.0 ± 4.3 cm3 vs 5.1 ± 1.9 cm3, P<.01), retropharyngeal nodes (3.0 ± 1.9 cm3 vs 2.2 ± 0.9 cm3, P<.05), and deep cervical nodes (15.7 ± 5.7 cm 3 vs 12.7 ± 4.0 cm3, 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 CO2 (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 cm3 vs 3.7 ± 1.6 cm 3, P<.01), and significantly larger adenoid (8.4 ± 4.1 cm3 vs 6.0 ± 2.2 cm3, P<.01), tonsils (7.0 ± 4.3 cm3 vs 5.1 ± 1.9 cm3, P<.01), retropharyngeal nodes (3.0 ± 1.9 cm3 vs 2.2 ± 0.9 cm3, P<.05), and deep cervical nodes (15.7 ± 5.7 cm 3 vs 12.7 ± 4.0 cm3, 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 CO2 (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.
UR - http://www.scopus.com/inward/record.url?scp=84863797461&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84863797461&partnerID=8YFLogxK
U2 - 10.1378/chest.11-2013
DO - 10.1378/chest.11-2013
M3 - Article
C2 - 22241762
AN - SCOPUS:84863797461
SN - 0012-3692
VL - 142
SP - 94
EP - 100
JO - Diseases of the chest
JF - Diseases of the chest
IS - 1
ER -