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Upper airways sarcoidosis presenting as obstructive sleep apnoea
R N Shah1, P R Mills, P J George
1Department of Respiratory Medicine, London Chest Hospital, UK.
Thorax
|July 11, 1998
Summary
Sarcoidosis, a multisystem disease, can manifest unusually. This case highlights severe obstructive sleep apnea caused by upper airway sarcoid infiltration, a presentation not previously documented.
Area of Science:
- Pulmonary Medicine
- Otolaryngology
- Sleep Medicine
Background:
- Sarcoidosis is a multisystem inflammatory disease of unknown etiology.
- It commonly affects the lungs but can involve any organ system.
- Airway involvement in sarcoidosis is rare and often presents insidiously.
Observation:
- A 32-year-old woman presented with severe obstructive sleep apnea (OSA).
- Diagnostic evaluation revealed infiltration of the upper airway by sarcoidosis.
- This infiltration was the direct cause of her severe OSA symptoms.
Findings:
- The patient's OSA was directly attributable to upper airway obstruction by sarcoid granulomas.
- Imaging and biopsy confirmed sarcoidosis involvement of laryngeal and pharyngeal structures.
- This represents a novel and severe manifestation of extrathoracic sarcoidosis.
Implications:
- This case expands the known clinical spectrum of sarcoidosis.
- It underscores the importance of considering sarcoidosis in the differential diagnosis of severe OSA, even without typical pulmonary findings.
- Early recognition and management of airway sarcoidosis are crucial to prevent significant morbidity.