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Nasser R, Vervloet T, Eckley CA, Amade S, Dokkedal-Silva V, Pires GN, Andersen ML, Tufik S, Longui C, Xavier SD. 0881 Clinical Evaluation of Adeno-Tonsillar Hyperplasia in Non-Syndromic Children and Adolescents During Growth Hormone Treatment. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Recombinant human Growth Hormone (rhGH) is an important pharmacological agent for linear growth stimulation and body composition in children with growth hormone deficiency (GHD). However, reports indicate that treatment with rhGH can be associated with adeno-tonsillar hyperplasia. This condition can lead to occurrence of obstructive sleep apnea (OSA) and worsening of sleep and life quality. Nonetheless, studies assessing this outcome in non-syndromic children are scarce.
Methods
We evaluated the difference in size of pharyngeal and palatine tonsils in patients aged between 5 and 17 being treated with recombinant human Growth Hormone (rhGH). We conducted a prospective longitudinal observational study. Twelve patients in treatment with rhGH were evaluated by otorhinolaryngological physical examination, nasofibrolaryngoscopy and obstructive sleep apnea (OSA)-18 questionnaire in two different time-points: when selected (T0) and after 6 months (T1).
Results
No significant associations were found regarding palatine and pharyngeal tonsil size with rhGH treatment. In relation to OSA 18 questionnaires, there was no statistically significant result in the absence of covariables for the general score as well as for the five domains that it comprises. When covariables were included in the analyses, controlled by the patients age, we observed statistically significant increases in the general score and in the domains relating to sleep disorders, emotional suffering, diurnal problems and the caretaker′s concerns.
Conclusion
In the present study, pharyngeal or palatine tonsils hyperplasia were infrequent during treatment with rhGH in the non-syndromic children and adolescents. However, the impact on sleep and quality of life that may arise warrant careful monitoring during therapy.
Support
Associação Fundo de Incentivo à Pesquisa (AFIP).
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Affiliation(s)
- R Nasser
- Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, BRAZIL
| | - T Vervloet
- Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, BRAZIL
| | - C A Eckley
- Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, BRAZIL
| | - S Amade
- Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, BRAZIL
| | | | - G N Pires
- Universidade Federal de Sao Paulo, Sao Paulo, BRAZIL
| | - M L Andersen
- Universidade Federal de Sao Paulo, Sao Paulo, BRAZIL
| | - S Tufik
- Universidade Federal de Sao Paulo, Sao Paulo, BRAZIL
| | - C Longui
- Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, BRAZIL
| | - S D Xavier
- Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, BRAZIL
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