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

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

J Laryngol Otol. 2015 Jun;129(6):572-9

Authors: Krishnan U, Paul S, Messina I, Soma M

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.

PMID: 26004028 [PubMed - indexed for MEDLINE]

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