PICKWICKIAN SYNDROME Meaning and
Definition
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Pickwickian syndrome is a medical condition characterized by the coexistence of obesity, sleep apnea, and hypoventilation. The name of the syndrome was inspired by the character Mr. Pickwick from Charles Dickens' novel "The Pickwick Papers," who was depicted as a jovial, stout man with a tendency for drowsiness. This syndrome is primarily associated with severe cases of obesity and is often observed in individuals with a high body mass index (BMI).
The primary feature of Pickwickian syndrome is obesity hypoventilation syndrome (OHS), where individuals experience abnormally low levels of oxygen and elevated levels of carbon dioxide in their blood. This occurs due to a combination of factors, including excess weight that affects lung mechanics and leads to decreased lung volumes and shallow breathing during sleep. Sleep apnea is commonly present in these individuals, causing frequent disruptions in breathing patterns during sleep.
Symptoms of Pickwickian syndrome may include excessive daytime sleepiness, drowsiness, morning headaches, fatigue, and difficulty concentrating. If left untreated, it can lead to more severe complications such as cor pulmonale (enlargement and failure of the right side of the heart), pulmonary hypertension, and heart failure.
Treatment for Pickwickian syndrome revolves around weight management, which typically involves a combination of lifestyle changes, diet modifications, and physical activity. In some cases, continuous positive airway pressure (CPAP) therapy may be used to alleviate sleep apnea symptoms and improve oxygen levels during sleep.
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Etymology of PICKWICKIAN SYNDROME
The word "Pickwickian Syndrome" is derived from the character named Samuel Pickwick in Charles Dickens' novel, "The Pickwick Papers" (1836). The term was coined by Sir William Hale-White, a British physician, to describe a set of symptoms associated with obesity and hypoventilation during sleep.
In the novel, Samuel Pickwick is portrayed as an extremely stout and jovial character. He frequently experiences episodes of heavy snoring and daytime sleepiness, which are reminiscent of the symptoms later associated with obesity hypoventilation syndrome (OHS), also known as Pickwickian Syndrome.
Sir William Hale-White, while working at Guy's Hospital in London in the late 19th century, observed patients who shared similar symptoms to Samuel Pickwick.
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