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Canadian Respiratory Journal
Volume 2016, Article ID 9712579, 2 pages
Images in Respiratory Medicine

An Adverse Reaction in the Pediatric Sleep Laboratory

1Division of Respiratory Medicine, Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada M5G IX8
2University of Toronto, Toronto, ON, Canada
3Janeway Children’s Health and Rehabilitation Centre, St. John’s, NL, Canada A1B 3V6

Received 6 April 2015; Accepted 27 August 2015

Copyright © 2016 Diana Reppucci et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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.