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Chronic lymphatic leukaemia presenting as severe obstructive sleep apnoea
1Department of Thoracic Medicine, Prince Charles Hospital, Chermside, Brisbane, Queensland, Australia.
Respirology (Carlton, Vic.)
|December 1, 1996
Summary
Chronic lymphatic leukaemia can cause severe obstructive sleep apnoea (OSA). Surgical removal of enlarged tonsils improved symptoms, allowing effective low-pressure nasal continuous positive airway pressure (nCPAP) therapy.
Area of Science:
- Oncology
- Pulmonology
- Otolaryngology
Background:
- Chronic lymphatic leukaemia (CLL) can present with extranodal manifestations.
- Adenotonsillar enlargement is a potential complication of CLL, impacting the upper airway.
- Obstructive sleep apnoea (OSA) is a significant comorbidity that can affect patient quality of life.
Observation:
- A patient with CLL experienced severe OSA due to adenotonsillar enlargement.
- Initial treatment with high-pressure nasal continuous positive airway pressure (nCPAP) was poorly tolerated and ineffective.
- Surgical intervention (tonsillectomy) led to partial improvement in OSA symptoms.
Findings:
- Tonsillectomy significantly reduced the severity of obstructive hypopnoeas.
- Following surgery, low-pressure nCPAP therapy became highly effective in managing residual OSA.
- This case demonstrates a successful multimodal treatment approach for OSA secondary to lymphoreticular disease.
Implications:
- Clinicians should consider OSA in adults with lymphoreticular malignancies presenting with constitutional symptoms.
- Involvement of Waldeyer's ring in lymphoreticular disease warrants evaluation for upper airway obstruction and OSA.
- A tailored treatment strategy combining surgical intervention and CPAP may be beneficial for managing OSA in this patient population.