RESUMO
Renal abnormalities in patients with obstructive sleep apnea syndrome (OSAS) have not been previously described. Medical records of patients who had been evaluated for possible sleep apnea syndrome and had had complete polysomnograms and urinalyses were reviewed to determine the frequency of proteinuria. High-grade proteinuria (greater than or equal to 3+ on urinalysis) was found in 6 of the 34 patients with obstructive sleep apnea, but in none of 34 patients in a control group matched for sex, age, and weight. In three patients, proteinuria was in the nephrotic range (3.5 g/24 h). The weight (mean +/- SD) of the patients with obstructive sleep apnea (112.7 +/- 35.3 kg) was not significantly different from the control group (109.2 +/- 30.3 kg). Microscopic examination of renal tissue in one patient with OSAS showed minimal changes. In four patients who were followed for 3 years, proteinuria improved after therapy for sleep apnea syndrome. We suggest that proteinuria may not be uncommon in patients with severe obstructive sleep apnea syndrome and may be reversible with correction of the sleep apnea syndrome.
Assuntos
Síndrome Nefrótica/etiologia , Proteinúria/etiologia , Síndromes da Apneia do Sono/complicações , Adulto , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Síndromes da Apneia do Sono/cirurgiaRESUMO
Four patients with mild to moderate obstructive sleep apnea were monitored first in the supine posture to establish a diagnosis of obstructive sleep apnea (apnea indices 33, 12, 22, 36). A second polysomnogram, obtained while the patients slept in the lateral posture, showed a dramatic decrease in apnea (apnea indices 5, 0, 0.2, and 0) and snoring. Each patient had an enlarged uvula, which moved to the side in the lateral posture. We conclude that sleeping in the lateral posture may be therapeutic in some patients with obstructive sleep apneas.
Assuntos
Postura , Síndromes da Apneia do Sono/terapia , Adulto , Idoso , Feminino , Humanos , Masculino , Monitorização Fisiológica/métodos , Síndromes da Apneia do Sono/complicações , Síndromes da Apneia do Sono/fisiopatologia , Ronco/etiologiaRESUMO
A 31-year-old black male experienced severe recurrent urticaria and angioedema during meals. An abnormal sialographic pattern indicated submandibular sialoadenitis, and surgical excision of the gland resulted in complete resolution of the urticaria. This report describes the association of sialoadenitis and urticaria and possible mechanisms involved.
Assuntos
Doenças das Glândulas Salivares/complicações , Sialadenite/complicações , Urticária/complicações , Adulto , Humanos , Masculino , Sialadenite/terapia , Glândula Submandibular/patologia , Glândula Submandibular/cirurgia , Urticária/terapiaRESUMO
Many cardiorespiratory problems have been identified in patients with sleep apnea syndrome. Acute pulmonary edema as the primary feature of obstructive sleep apnea has recently been reported, and is thought to be caused by the effects of severe hypoxemia and/or extreme negative intrathoracic pressure. We have described another patient with sleep apnea syndrome who had pulmonary edema on at least three different occasions. Extremely high pulmonary artery pressure, paradoxic motion of the interventricular septum, and very low right heart ejection fraction were found. The paradoxic septal motion disappeared and the right heart ejection fraction increased after tracheostomy.