THE PICKWICKIAN SYNROME CASE
The article demonstrates a clinical case of Pickwickian syndrome. The clinical manifestation of the syndrome, a diagnostic approach including instrumental methods, and the up-to-date treatment based on the literature data are shown. The significance of maintaining lifestyle modification with accent on a normalization of body mass is emphasized.
There are two tasks in the treatment of Pickwickian syndrome: maintaining a healthy body weight and oxygen therapy. Weight loss is achieved first of all by the lifestyle modification, which means a hypocaloric diet, rational physical activity and also drugs therapy, which opportunities are rather limited. If conservative treatment for obesity is non-effective the expediency of the surgical intervention should be taken into account. Bariatric surgery has been shown to be the most effective modality of reliable and durable treatment for severe obesity. In practice, several mini-invasive and invasive surgical approaches exist to achieve the optimal weight in obese patients with or without obesity-hypoventilation syndrome. According to the guidelines issued by the National Institutes of Health, patients with body mass index greater than 35 kg/m2 and an obesity-related comorbid condition (including obesity-hypoventilation syndrome) or patients with a body mass index greater than 40 kg/m2 can be referred for surgical treatment. The second task can be achieved by noninvasive ventilation bi-level positive airway pressure (inspiratory and expiratory positive airway pressure).
Littleton S. W. The pickwickian syndrome-obesity hypoventilation syndrome. / S. W. Littleton,
B. Mokhlesi // Clin Chest Med. – 2009. – No. 30 (3). – p. 467–478.
HealthCentral Encyclopedia [electronic resource]. – Access mode: https://www.healthcentral.com/encyclopedia/p/pickwickian-syndrome – overview.
Mokhlesi B. Obesity Hypoventilation Syndrome: A State-of-the-Art Review / B. Mokhlesi // Respir. Care. – 2010. – No. 55 (10). – p. 1347–1365.
Piepoli M. F. 2016 European guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts)Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR) / M. F. Piepoli, A. W. Hoes, S. Agewall et al] // Eur Heart J. – 2016. – No. 37 (29). – p. 2315–2381.
Knipe H. Pickwickian syndrome [electronic resource] / H. Knipe, R. Pfleger. – Access mode: https://radiopaedia.org/articles/pickwickian-syndrome – overview.
Akboga M. K. Platelet to lymphocyte ratio as a novel indicator of inflammation is correlated with the severity of metabolic syndrome: A single center large-scale study / M. K. Akboga, U. Canpolat,
M. Yuksel et al] // Platelets. – 2016. – No. 27. – p. 178–183.
Jung U. J. Obesity and its metabolic complications: the role of adipokines and the relationship between obesity, inflammation, insulin resistance, dyslipidemia and nonalcoholic fatty liver disease / U. J. Jung, M. S. Choi // Int J Mol Sci. – 2014. – No. 15 (4). – p. 6184–6223.
Pearson T. A. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: A statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. / T. A. Pearson, G. A. Mensah, R. W. Alexander, et al] // Circulation. – 2003. – No. 107 (3). – p. 499–511.
Casas J.P. C-reactive protein and coronary heart disease: a critical review. / J.P. Casas, T. Shah, A.D. Hingorani, et al] // J Intern Med. –2008. – No. 264(4).–p. 295–314.
Edmond H. L. Obesity Hypoventilation Syndrome and Anesthesia / H. L. Edmond, B. Mokhlesi, F. Chung // Sleep Med Clin. – 2013. – No. 8(1). – p. 135–147.
Geraldo M. S. The use of drugs in patients who have undergone bariatric surgery / M. S. Geraldo, F. L. Fonseca, M. R.Gouveia, D. Feder // Int J Gen Med. – 2014. – No. 14. – p. 219–224.
Copyright (c) 2017 The Journal of V. N. Karazin Kharkiv National University, series "Medicine"
This work is licensed under a Creative Commons Attribution 4.0 International License.
The Journal of V. N. Karazin Kharkiv National University, series Medicine has following copyright terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work’s authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal’s published version of the work, with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.