title: Reversible Severe Pulmonary Hypertension after Adenotonsillectomy: A Case Report of a Child Treated at Bugando Medical Centre, Northwestern Tanzania.
abstract: Upper airway obstruction (UAO) due to adenotonsillar hypertrophy represents one of the rare causes of pulmonary hypertension in children. We report a case of adenotonsillar hypertrophy, managed at pediatric and otorhinolaryngology departments in Bugando Medical Centre (BMC), northwestern Tanzania, with complete remission of symptoms of pulmonary hypertension following adenotonsillectomy. A 17-month-old boy presented with difficulty breathing, dry cough, and noisy breathing since 1 year. He had facial and lower limb oedema with a pan systolic murmur at the tricuspid area, fine crepitations, and tender hepatomegaly. A grade II tonsillar hypertrophy and hypertrophied adenoids were seen on nasal and throat evaluation. A 2D-echocardiography showed grossly distended right atrium and ventricle, dilated pulmonary artery, and grade III tricuspid regurgitation. His final diagnosis was severe pulmonary hypertension with right-sided heart failure due to adenotonsillar hypertrophy. He had complete remission of cardiopulmonary symptoms after adenotonsillectomy and had normal control echocardiography six and twelve months after surgery. Children with symptoms of upper airway obstruction and cardiopulmonary involvement could benefit from routine screening for pulmonary hypertension. Adenotonsillectomy should be considered for possible complete remission of both UAO and cardiopulmonary symptoms.
authors.affiliation: Department of Pediatrics, Bugando Medical Centre, P.O. Box 1370, Mwanza, Tanzania; Department of Pediatrics, Catholic University of Health and Allied Sciences-Bugando, P.O. Box 1464, Mwanza, Tanzania.
authors.forename: Rogatus
authors.identifier: 0000-0002-7441-1123
authors.initials: R
authors.lastname: Kabyemera
authors.affiliation: Department of Pediatrics, Bugando Medical Centre, P.O. Box 1370, Mwanza, Tanzania; Department of Pediatrics, Catholic University of Health and Allied Sciences-Bugando, P.O. Box 1464, Mwanza, Tanzania.
authors.forename: Neema
authors.initials: N
authors.lastname: Chami
authors.affiliation: Department of Pediatrics, Bugando Medical Centre, P.O. Box 1370, Mwanza, Tanzania; Department of Pediatrics, Catholic University of Health and Allied Sciences-Bugando, P.O. Box 1464, Mwanza, Tanzania.
authors.forename: Neema
authors.initials: N
authors.lastname: Kayange
authors.affiliation: Department of Pediatrics, Bugando Medical Centre, P.O. Box 1370, Mwanza, Tanzania; Department of Pediatrics, Catholic University of Health and Allied Sciences-Bugando, P.O. Box 1464, Mwanza, Tanzania.
authors.forename: Respicius
authors.initials: R
authors.lastname: Bakalemwa
authors.affiliation: Department of Pediatrics, Bugando Medical Centre, P.O. Box 1370, Mwanza, Tanzania; Department of Pediatrics, Catholic University of Health and Allied Sciences-Bugando, P.O. Box 1464, Mwanza, Tanzania.
authors.forename: Antke
authors.initials: A
authors.lastname: Zuechner
authors.affiliation: Department of Pediatrics, Bugando Medical Centre, P.O. Box 1370, Mwanza, Tanzania; Department of Pediatrics, Catholic University of Health and Allied Sciences-Bugando, P.O. Box 1464, Mwanza, Tanzania.
authors.forename: Tumaini
authors.initials: T
authors.lastname: Mhada
authors.affiliation: Department of Otorhinolaryngology, Bugando Medical Centre, P.O. Box 1370, Mwanza, Tanzania.
authors.forename: Gustave
authors.identifier: 0000-0003-4576-199X
authors.initials: G
authors.lastname: Buname
authors.affiliation: Department of Pediatrics, Bugando Medical Centre, P.O. Box 1370, Mwanza, Tanzania; Department of Pediatrics, Catholic University of Health and Allied Sciences-Bugando, P.O. Box 1464, Mwanza, Tanzania.
authors.forename: Adolfine
authors.identifier: 0000-0002-0265-1101
authors.initials: A
authors.lastname: Hokororo
authors.affiliation: Department of Internal Medicine, Bugando Medical Centre, P.O. Box 1370, Mwanza, Tanzania; Department of Internal Medicine, Catholic University of Health and Allied Sciences-Bugando, P.O. Box 1464, Mwanza, Tanzania.
authors.forename: Johannes
authors.initials: J
authors.lastname: Kataraihya