BMJ Case Reports 2012; doi:10.1136/bcr-2012-007059
  • Rare disease

Severe obstructive sleep apnoea due to adenotonsillar hypertrophy after liver transplantation

  1. Lindsey Knight1
  1. 1Department of ENT Surgery, Leeds General Infirmary, Leeds, UK
  2. 2Department of ENT Surgery, Barts & the London Hospitals, London, UK
  1. Correspondence to Omar Mulla, omarmulla22{at}


Epstein-Barr virus-related adenotonsillar hypertrophy is a precursor to post-transplantation lymphoproliferative disorder. We report a case of a 4-year-old child with severe obstructive sleep apnoea, who had liver transplantation at the age of 7 months. She had gross lymphoid hypertrophy in the oropharynx and supraglottis. We performed an adenotonsillectomy and aryepiglottoplasty which improved her symptoms. We emphasise the importance to consider the diagnosis of post-transplantation lymphoproliferative disorder in post-transplantation immunosuppressed patients who present with adenotonsillar hypertrophy.

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