Obstructive sleep apnoea secondary to superior vena cava thrombosis in a patient with activated protein C resistance
Tóm tắt
Only five cases of superior vena cava (SVC) thrombosis as a cuase of obstructive sleep apnoea (OSA) have as yet been reported. In this study, we aimed to describe an additional case and to review the literature on this subject. Based on the medical records, the case history of a 58-year-old man with OSA due to SVC thrombosis is presented. Furthermore, PubMed articles were browsed with the search items ‘sleep apnoea’ and ‘superior vena cava thrombosis’. The patient complained of the development of facial swelling and plethora during the previous 2 months. Furthermore, he reported the recent onset of snoring and excessive daytime sleepiness. Computed tomography of the thorax and mediastinal phlebography showed SVC thrombosis. Polysomnography demonstrated moderate to severe OSA. The cases of OSA secondary to SVC thrombosis already reported in the literature were mainly caused by mediastinal tumours compressing the SVC. In the present case, we found activated protein C (APC) resistance as the underlying disease. From the literature, it is known that therapies aimed at recanalization or relief of the SVC might lead to reversal of the OSA. In our patient, recanalization of the SVC was not possible and thus he had to be treated by continuous positive airway pressure therapy. In summary, we report on the rare occurrence of OSA due to SVC thrombosis. In the present case we found APC resistance as the underlying disease, which has not yet been reported in the literature.
Tài liệu tham khảo
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