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A Pediatric Patient with Idiopathic Short Stature Who Developed Obstructive Sleep Apnea after Starting Growth Hormone

Morkous Ss1,2,3

  • 1Department of Pediatrics, Pediatric Neurology Division, Lehigh Valley Children's Hospital, Allentown, PA, USA.

Journal of Molecular and Genetic Medicine : an International Journal of Biomedical Research
|February 6, 2018
PubMed

Insights

Growth hormone (GH) therapy may worsen obstructive sleep apnea (OSA) in children. This case study suggests careful sleep monitoring during GH treatment for idiopathic short stature is needed.

Area of Science:

  • Pediatric Endocrinology
  • Sleep Medicine
  • Genetics

Background:

  • Growth hormone (GH) therapy is suspected to induce obstructive sleep apnea (OSA).
  • Concerns exist regarding GH worsening sleep apnea, particularly in Prader-Willi syndrome (PWS).
  • Routine polysomnography (PSG) is recommended for PWS patients before GH, but not established for other pediatric groups.

Purpose of the Study:

  • To highlight the potential link between GH therapy and the development of OSA in pediatric patients.
  • To emphasize the need for vigilance regarding sleep-related side effects of GH treatment.
  • To advocate for further research into PSG guidelines for GH-eligible children.

Main Methods:

  • Case report of a 15-year-old male with headaches and short stature.
  • Initial sleep study showed mild snoring; a follow-up study after GH therapy revealed significantly worsened obstructive sleep apnea.
  • Surgical intervention (tonsillectomy and adenoidectomy) led to symptom resolution.

Main Results:

  • A 15-year-old patient on GH therapy experienced a dramatic increase in his obstructive apnea-hypopnea index.
  • Symptoms of worsening sleep apnea resolved post-tonsillectomy and adenoidectomy.
  • The case underscores a potential complication of GH therapy.

Conclusions:

  • GH therapy may necessitate careful consideration of sleep apnea risks.
  • Further research is needed to establish definitive guidelines for PSG before and during GH therapy in children with idiopathic short stature and initially normal sleep studies.
  • Caution is advised for all patients eligible for GH therapy regarding potential sleep disturbances.
Abstract

Keywords:
Growth hormoneGrowth hormone therapyIdiopathic short statureObstructive sleep apneaPediatricsPrader-Willi syndrome

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