The Pickwickian Syndrome in a Child

Abstract

A 10-year-8-month-old girl with the Pickwickian syndrome was presented. In this case, asthmatic bronchitis preceded the development of the Pickwickian syndrome. There was no mental retardation. Pulmonary function tests revealed a pattern of hypoventilation: reduc tion in tidal volume, inspiratory capacity, maximum breathing capacity and timed vital capacity, and increase in functional residual capacity, residual volume and the residual volume/total lung capacity ratio. Further, forced expiratory volume for one second/forced vital capacity, maximal midexpiratory flow, the air velocity index and the expiratory check valve index were also found to be reduced, suggesting the existence of airway obstruction. From the clincial symptoms, course and pulmonary function tests of our case, it was assumed that in our case, bronchial obstruction due to asthmatic bronchitis, in combination with malfunction of the respiratory muscles due to obesity, played an important role in the development of the syndrome.