Obstructive sleep apnea in a 5 month old with tonsillar hypertrophy secondary to congenital neutropenia: Case report and literature review

Tonsillectomy and adenoidectomy (T&A) is the primary surgical treatment for obstructive sleep apnea (OSA) in children with tonsillar and adenoid hypertrophy (TAH). We present the case of a 5-month old male with congenital neutropenia who developed severe TAH during treatment with granulocyte colony-stimulating factor (G-CSF). He had severe OSA, decreased oral intake, and failure to thrive (FTT) which all improved after undergoing a successful intracapsular T&A. We describe a successful procedure to help alleviate symptoms of OSA and FTT in this young infant with congenital neutropenia who developed TAH during treatment with G-CSF. It highlights the need for further research into the pathophysiology of TAH in immunocompromised children and the effects of G-CSF on Waldeyer's Ring.