Upper airway obstruction-related sleep apnea in a child with thalassemia intermedia

Obstructive sleep apnea can be caused by hypertrophy of tonsils and adenoid s or neuromuscular diseases. The authors describe a child with thalassemia intermedia in whom severe obstructive sleep apnea syndrome developed. Compu ted tomography scanning revealed an obstruction of the nasopharynx resultin g from extramedullary hematopoiesis. The child was treated with hydroxyurea and blood transfusions. Relief of symptoms was noted 1.5 months after init ial treatment. Extramedullary hematopoiesis causes sleep apnea syndrome in thalassemic patients, and the treatment of hydroxyurea and blood transfusio n for extramedullary hematopoiesis should be further studied.