Correlation between laryngobronchoscopy and pepsin in the diagnosis of extra-oesophageal reflux.

Abstract

OBJECTIVE:

This study aimed to investigate pepsin as a marker of extra-oesophageal reflux disease by examining its presence in tracheal aspirates and correlating it with macroscopic changes on laryngobronchoscopy, along with the results of standard tests for gastro-oesophageal reflux disease and clinical features.

METHODS:

A retrospective review was undertaken of a cohort of 188 paediatric patients who underwent laryngobronchoscopy at a tertiary children's hospital and for whom pepsin assay results of tracheal aspirates were available. An association analysis was performed.

RESULTS:

The mean patient age was 3.99 (3.40-4.58) years, with a male preponderance (55 per cent). Positive changes on laryngobronchoscopy were significantly associated with positive tracheal pepsin findings (p < 0.0001) but not with positive standard gastro-oesophageal reflux disease investigations. A positive pepsin assay was significantly associated with a history of recurrent croup (p = 0.0385) and a diagnosis of cystic fibrosis (p = 0.0232).

CONCLUSION:

Macroscopic changes on laryngobronchoscopy were significantly associated with positive tracheal pepsin findings in this paediatric population, suggesting that extra-oesophageal reflux disease may be a contributing aetiology.

• Authors: U Krishnan, S Paul, I Messina, M Soma
• Journal: The Journal of laryngology and otology (J Laryngol Otol) Vol. 129 Issue 6 Pg. 572-9 (Jun 2015) ISSN: 1748-5460 [Electronic] England
• PMID: 26004028 (Publication Type: Journal Article)

Chemical References

• Biomarkers
• Pepsin A

Topics

• Biomarkers (metabolism)
• Bronchoscopy (methods)
• Child, Preschool
• Croup (diagnosis, etiology, metabolism)
• Diagnosis, Differential
• Esophagus (metabolism, pathology)
• Female
• Gastroesophageal Reflux (complications, diagnosis, metabolism)
• Humans
• Laryngoscopy (methods)
• Male
• Pepsin A (metabolism)
• Retrospective Studies