title: The validity of the OSA-18 among three groups of pediatric patients.
abstract: OBJECTIVE
  To compare the signs and symptoms of obstructive sleep apnea syndrome in three groups of pediatric patients; solid organ transplant recipients, healthy children, and children with leukemia; in order to examine the effects of chronic illness on the obstructive sleep apnea-18-item questionnaire and to investigate its validity as a screening tool for obstructive sleep apnea in the pediatric solid organ transplant population.
  
  
  METHODS
  In this cross-sectional study, there were two hundred and six subjects; 46 kidney transplant recipients, 59 liver transplant recipients, 34 patients with leukemia, and 67 healthy children. Adenotonsillar enlargement was assessed by using the obstructive sleep apnea-18-item questionnaire and by performing a focused physical examination of the oral and nasal cavity at the time of the child's routine visit in either the transplant clinic, outpatient oncology center, or general pediatric clinic.
  
  
  RESULTS
  Comparison of questionnaire scores amongst the three groups showed significant differences between the healthy children and liver transplant recipients as well as those with leukemia. There was a significant difference in the physical examination scores of the children with leukemia as compared to the other groups.
  
  
  CONCLUSIONS
  Adenotonsillar enlargement in pediatric transplant recipients can be an early indication of post-transplantation lymphoproliferative disorder. However, the prevalence of adenotonsillar enlargement in the transplant population does not appear to differ from that of the healthy population. Additionally, scores on the OSA-18 in the transplant population were confounded by chronic illness. Further prospective studies need to be performed to develop a screening tool to identify transplant recipients at risk for post-transplantation adenotonsillar lymphoma.
authors.affiliation: Department of Surgery, Division of Head and Neck Surgery, University of California Los Angeles Medical Center, USA.
authors.forename: Ali M
authors.initials: AM
authors.lastname: Strocker
authors.forename: Alexandra
authors.initials: A
authors.lastname: Carrer
authors.forename: Nina L
authors.initials: NL
authors.lastname: Shapiro
mesh_terms: D000234:Adenoids / Q000473:pathology*; D000293:Adolescent; D002140:California; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D006801:Humans; D006984:Hypertrophy; D016030:Kidney Transplantation / Q000009:adverse effects; D007938:Leukemia / Q000150:complications; D016031:Liver Transplantation / Q000009:adverse effects; D008232:Lymphoproliferative Disorders / Q000175:diagnosis*; D008403:Mass Screening; D014066:Palatine Tonsil / Q000473:pathology*; D010808:Physical Examination; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis*; D011795:Surveys and Questionnaires