Clinical Utility of Bronchoalveolar Lavage Pepsin in Diagnosis of Gastroesophageal Reflux among Wheezy Infants
Joint Authors
Abdallah, Ahmed Fathi
El-Desoky, Tarek
Fathi, Khalid
Elkashef, Wagdy Fawzi
Zaki, Ahmed
Source
Issue
Vol. 2016, Issue 2016 (31 Dec. 2016), pp.1-7, 7 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2016-07-19
Country of Publication
Egypt
No. of Pages
7
Main Subjects
Abstract EN
Background.
There is no gold standard test for diagnosis of gastroesophageal reflux disease (GERD) associated infantile wheezing.
Objectives.
To evaluate the value of bronchoalveolar lavage (BAL) pepsin assay in diagnosis of GERD in wheezy infants.
Methods.
Fifty-two wheezy infants were evaluated for GERD using esophageal combined impedance-pH (MII-pH) monitoring, esophagogastroduodenoscopy with esophageal biopsies, and BAL pepsin.
Tracheobronchial aspirates from 10 healthy infants planned for surgery without history of respiratory problems were examined for pepsin.
Results.
Wheezy infants with silent reflux and wheezy infants with typical GERD symptoms but normal MII-pH had significantly higher BAL pepsin compared to healthy control (45.3 ± 8.6 and 42.8 ± 8 versus 29 ± 2.6, P < 0.0001 and P = 0.011 , resp.).
BAL pepsin had sensitivity (61.7%, 72 %, and 70%) and specificity (55.5%, 52.9%, and 53%) to diagnose GERD associated infantile wheeze compared to abnormal MII-pH, reflux esophagitis, and lipid laden macrophage index, respectively.
Conclusion.
A stepwise approach for assessment of GERD in wheezy infants is advised.
In those with silent reflux, a trial of antireflux therapy is warranted with no need for further pepsin assay.
But when combined MII-pH is negative despite the presence of typical GERD symptoms, pepsin assay will be needed to rule out GERD related aspiration.
American Psychological Association (APA)
Abdallah, Ahmed Fathi& El-Desoky, Tarek& Fathi, Khalid& Elkashef, Wagdy Fawzi& Zaki, Ahmed. 2016. Clinical Utility of Bronchoalveolar Lavage Pepsin in Diagnosis of Gastroesophageal Reflux among Wheezy Infants. Canadian Respiratory Journal،Vol. 2016, no. 2016, pp.1-7.
https://search.emarefa.net/detail/BIM-1103264
Modern Language Association (MLA)
Abdallah, Ahmed Fathi…[et al.]. Clinical Utility of Bronchoalveolar Lavage Pepsin in Diagnosis of Gastroesophageal Reflux among Wheezy Infants. Canadian Respiratory Journal No. 2016 (2016), pp.1-7.
https://search.emarefa.net/detail/BIM-1103264
American Medical Association (AMA)
Abdallah, Ahmed Fathi& El-Desoky, Tarek& Fathi, Khalid& Elkashef, Wagdy Fawzi& Zaki, Ahmed. Clinical Utility of Bronchoalveolar Lavage Pepsin in Diagnosis of Gastroesophageal Reflux among Wheezy Infants. Canadian Respiratory Journal. 2016. Vol. 2016, no. 2016, pp.1-7.
https://search.emarefa.net/detail/BIM-1103264
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1103264