Respiratory distress in a neonate with an enlarged thymus

Dimitriou, Gabriel; Greenough, Anne; Rafferty, Gerrard F.; Rennie, Janet M.; Karani, John

doi:10.1007/s004310050061

Cited by 9 publications

(1 citation statement)

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“…Thymus hyperplasia is defined as an enlarged thymus consisting of normal thymic tissue, it is generally asymptomatic. Some authors have reported cases of enlarged thymus leading to respiratory symptoms (dyspnea, cough, stridor or wheezing) (1,2), early in infancy. Normal evolution is involution with disappearance of respiratory symptom before the third year of life.…”

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confidence: 99%

Benign thymic hyperplasia: an unexpected cause of respiratory distress during inhalatory induction of anesthesia

Piednoir¹,

Taylor²,

Gayat³

et al. 2008

Pediatric Anesthesia

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agitation leading to biting on the LMA and dislodgement of the intravenous cannula.Based on our experience and previous reports, we suggest the use of shorter acting agents like remifentanil and desflurane along with bispectral index monitoring to enable quick recovery. If LMA is left in situ, use of bite block is highly recommended. Alternatively, it may be removed under deep anesthesia on resumption of spontaneous respiration. Muscular dystrophy may be undiagnosed in patients with AS and it would be ideal to completely avoid muscle relaxants. If unavoidable, we suggest a significant reduction in the recommended dose and neuromuscular monitoring. The postoperative aggressive behavior could be explained by pre-and ⁄ or postoperative anxiety, a feature not uncommon in patients with learning disability, or was it sevoflurane emergence?Angelman syndrome is a rare syndrome and the average life expectancy in AS is known to be short. Given the limited literature in the perioperative anesthetic management of these patients, we hope that our experience along with the previous case reports will contribute to better anesthetic management of these children in the future.J a y ap r a ka s h J P a t i l S ee m a Si n dha k a r

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confidence: 99%