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A Clinical Encounter With Pickwickian Syndrome

The clinical syndrome described in the literature as "Pickwickian syndrome" is characterized by a combination of sleep-disordered breathing, obesity, and daytime hypercapnia; the condition is also known as obesity hypoventilation syndrome (OHS). This syndrome is a diagnosis of exclusion af...

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Autores principales: Upadhyay, Puja, Jadhav, Ulhas S, Aurangabadkar, Gaurang M, Lanjewar, Ajay V, Wagh, Pankaj, Ghewade, Babaji, Kadukar, Juhi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9532193/
https://www.ncbi.nlm.nih.gov/pubmed/36225419
http://dx.doi.org/10.7759/cureus.28778
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author Upadhyay, Puja
Jadhav, Ulhas S
Aurangabadkar, Gaurang M
Lanjewar, Ajay V
Wagh, Pankaj
Ghewade, Babaji
Kadukar, Juhi
author_facet Upadhyay, Puja
Jadhav, Ulhas S
Aurangabadkar, Gaurang M
Lanjewar, Ajay V
Wagh, Pankaj
Ghewade, Babaji
Kadukar, Juhi
author_sort Upadhyay, Puja
collection PubMed
description The clinical syndrome described in the literature as "Pickwickian syndrome" is characterized by a combination of sleep-disordered breathing, obesity, and daytime hypercapnia; the condition is also known as obesity hypoventilation syndrome (OHS). This syndrome is a diagnosis of exclusion after every other possible etiology is ruled out. Patients can present both with an exacerbation of or a chronic state of progressive dyspnea. In this report, we describe the case of a 62-year-old morbidly obese female with a BMI of 42 Kg/m(2), who presented with progressively worsening breathlessness. An arterial blood gas (ABG) analysis revealed severe hypoxia with hypercarbia. A sleep study [polysomnography (PSG)] of the patient was performed, which revealed an apnea-hypopnea index (AHI) of 58.2, and the patient was diagnosed as having OHS after all other possible cardiorespiratory etiologies were ruled out. The patient was promptly managed with non-invasive ventilatory (NIV) support along with supportive management and was prescribed overnight NIV and subsequently discharged in stable condition.
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spelling pubmed-95321932022-10-11 A Clinical Encounter With Pickwickian Syndrome Upadhyay, Puja Jadhav, Ulhas S Aurangabadkar, Gaurang M Lanjewar, Ajay V Wagh, Pankaj Ghewade, Babaji Kadukar, Juhi Cureus Internal Medicine The clinical syndrome described in the literature as "Pickwickian syndrome" is characterized by a combination of sleep-disordered breathing, obesity, and daytime hypercapnia; the condition is also known as obesity hypoventilation syndrome (OHS). This syndrome is a diagnosis of exclusion after every other possible etiology is ruled out. Patients can present both with an exacerbation of or a chronic state of progressive dyspnea. In this report, we describe the case of a 62-year-old morbidly obese female with a BMI of 42 Kg/m(2), who presented with progressively worsening breathlessness. An arterial blood gas (ABG) analysis revealed severe hypoxia with hypercarbia. A sleep study [polysomnography (PSG)] of the patient was performed, which revealed an apnea-hypopnea index (AHI) of 58.2, and the patient was diagnosed as having OHS after all other possible cardiorespiratory etiologies were ruled out. The patient was promptly managed with non-invasive ventilatory (NIV) support along with supportive management and was prescribed overnight NIV and subsequently discharged in stable condition. Cureus 2022-09-04 /pmc/articles/PMC9532193/ /pubmed/36225419 http://dx.doi.org/10.7759/cureus.28778 Text en Copyright © 2022, Upadhyay et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Upadhyay, Puja
Jadhav, Ulhas S
Aurangabadkar, Gaurang M
Lanjewar, Ajay V
Wagh, Pankaj
Ghewade, Babaji
Kadukar, Juhi
A Clinical Encounter With Pickwickian Syndrome
title A Clinical Encounter With Pickwickian Syndrome
title_full A Clinical Encounter With Pickwickian Syndrome
title_fullStr A Clinical Encounter With Pickwickian Syndrome
title_full_unstemmed A Clinical Encounter With Pickwickian Syndrome
title_short A Clinical Encounter With Pickwickian Syndrome
title_sort clinical encounter with pickwickian syndrome
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9532193/
https://www.ncbi.nlm.nih.gov/pubmed/36225419
http://dx.doi.org/10.7759/cureus.28778
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