1. 20-21 June 2014 – Vienna European Pneumo Update ePoster Obstructive sleep apnea in a school age child. Case report T. Marcovici, S. D. Mihaicuta, O. Marginean, O. Belei, D. Chiru, R. Tudorache University of Medicine and Pharmacy „Victor Babes”, Timisoara, Romania Department of Pediatrics, „Louis Turcanu” Children’s Emergency Hospital, Timisoara, Romania Department of Pneumology, Hospital of Infectious Diseases and TB „Dr.Victor Babes”, Timisoara, Romania

2. 20-21 June 2014 – Vienna European Pneumo Update ePoster  Objective Evaluation of complex sleep disorder in a 10 years boy with asthma and adenoids hypertrophy.  Methods  History  Physical examination  Laboratory investigations:  Biological  Imaging (conventional chest X-ray; cardiac/abdominal echography)  Functional (spirometry; overnight polygraphy; electrocardiography; electroencephalography)  Interdisciplinary evaluations:  cardiology; ENT; pulmonology; pediatric neuropsychiatry; psychology  Results  At age 5 were diagnosed :  Nocturnal sleep disturbances :  heavy snoring  enuresis  somnilocvia  ambulatory automatism  Hypertrophic adenoids  Atopic status  Poor growth and weight gain (BMI = 12.9 kg/m2)  Up to age 7 he presented:  recurrent respiratory infections  hyperkinesia/abnormal behavior/heteroaggression  school adaptation difficulties

3. 20-21 June 2014 – Vienna European Pneumo Update ePoster  Results  With normal sized tonsils, at age 8 was performed adenoidectomy.  Sleep polygraphy made after 12 months revealed severe obstructive sleep apnea (OSA):  AHI = 5.9/hour  desaturation index = 18/hour  mean SaO 2 = 94%  With treatment (sleep hygiene; montelukastum; individual/family psychological counseling), up to age 10 evolution was favorable:  bedwetting and sleep walking resolved  nutritional status (BMI=16.2 kg/m2) and adaptation to the school/social environment have improved significantly.  hyperactive disorder and snooring decreased.  spirometric parameters became normal.  Subsequent polygraphic recordings showed persistent OSA.  Conclusions  Although tonsils appear normal sized, tonsillectomy is required to reduce OSA.  Sleep study is the “gold standard” evaluation in the case presented.  Long term interdisciplinary follow-up is necessary.