An Adverse Reaction in the Pediatric Sleep Laboratory

We present a case of a 15-month-old boy with Cornelia de Lange Syndrome (NIPBL gene mutation). On a PSG, central sleep apnea (central apnea-hypopnea index of 19/hour) and nocturnal hypoventilation (transcutaneous CO2 > 50 mmHg for 53% of the night) were found. A positive pressure initiation study...

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Bibliographic Details
Published in:Canadian respiratory journal 2016-01, Vol.2016 (2016), p.1-2
Main Authors: Amin, Reshma, Smith, Mary Jane, Al-Saleh, Suhail, Medin, Debra, Reppucci, Diana, Barter, Jill
Format: Article
Language:English
Subjects:
Allergies
Anti-Infective Agents, Local - adverse effects
Care and treatment
Dermatitis
Dermatitis, Allergic Contact - etiology
Disinfection & disinfectants
Facial Dermatoses - chemically induced
Gene mutations
Genetic aspects
Humans
Images in Respiratory Medicine
Infant
Iodine
Laboratories
Male
Masks
Ostomy
Polysomnography
Positive-Pressure Respiration - instrumentation
Povidone-Iodine - adverse effects
Risk factors
Severity of Illness Index
Sleep apnea
Sleep apnea syndromes
Sleep Apnea, Central - therapy
Ventilation
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Summary:We present a case of a 15-month-old boy with Cornelia de Lange Syndrome (NIPBL gene mutation). On a PSG, central sleep apnea (central apnea-hypopnea index of 19/hour) and nocturnal hypoventilation (transcutaneous CO2 > 50 mmHg for 53% of the night) were found. A positive pressure initiation study was aborted because the patient developed a serious adverse reaction. The differential diagnosis included a skin fragility condition versus an allergic contact dermatitis to the interface; this could be from the povidone-iodine solution used to clean the NiPPV interface or from the plastic of the interface itself. A skin biopsy was performed which was normal. The reaction was likely secondary to an allergic contact dermatitis from the povidone-iodine solution used to clean the NiPPV interface. The patient is currently tolerating NiPPV.
ISSN:1198-2241
1916-7245
DOI:10.1155/2016/9712579