title: An Adverse Reaction in the Pediatric Sleep Laboratory.
abstract: We present a case of a 15-month-old boy with Cornelia de Lange Syndrome (NIPBL gene mutation). On a PSG, central sleep apnea (central apnea-hypopnea index of 19/hour) and nocturnal hypoventilation (transcutaneous CO2 > 50 mmHg for 53% of the night) were found. A positive pressure initiation study was aborted because the patient developed a serious adverse reaction. The differential diagnosis included a skin fragility condition versus an allergic contact dermatitis to the interface; this could be from the povidone-iodine solution used to clean the NiPPV interface or from the plastic of the interface itself. A skin biopsy was performed which was normal. The reaction was likely secondary to an allergic contact dermatitis from the povidone-iodine solution used to clean the NiPPV interface. The patient is currently tolerating NiPPV.
authors.affiliation: Division of Respiratory Medicine, Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada M5G IX8; University of Toronto, Toronto, ON, Canada.
authors.forename: Diana
authors.initials: D
authors.lastname: Reppucci
authors.affiliation: Division of Respiratory Medicine, Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada M5G IX8.
authors.forename: Debra
authors.initials: D
authors.lastname: Medin
authors.affiliation: Division of Respiratory Medicine, Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada M5G IX8; University of Toronto, Toronto, ON, Canada.
authors.forename: Suhail
authors.initials: S
authors.lastname: Al-Saleh
authors.affiliation: Janeway Children's Health and Rehabilitation Centre, St. John's, NL, Canada A1B 3V6.
authors.forename: Mary Jane
authors.initials: MJ
authors.lastname: Smith
authors.affiliation: Janeway Children's Health and Rehabilitation Centre, St. John's, NL, Canada A1B 3V6.
authors.forename: Jill
authors.initials: J
authors.lastname: Barter
authors.affiliation: Division of Respiratory Medicine, Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada M5G IX8; University of Toronto, Toronto, ON, Canada.
authors.forename: Reshma
authors.initials: R
authors.lastname: Amin
mesh_terms: D000891:Anti-Infective Agents, Local / Q000009:adverse effects*; D017449:Dermatitis, Allergic Contact / Q000209:etiology*; D005148:Facial Dermatoses / Q000139:chemically induced*; D006801:Humans; D007223:Infant; D008297:Male; D008397:Masks; D017286:Polysomnography; D011175:Positive-Pressure Respiration / Q000295:instrumentation; D011206:Povidone-Iodine / Q000009:adverse effects*; D012720:Severity of Illness Index; D020182:Sleep Apnea, Central / Q000628:therapy*
chemical_list: D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine