Evaluation of allergic sensitization and gastroesophageal reflux disease in children with recurrent croup

Arslan, Zafer; Çipe, Funda; Özmen, Serap; Kondolot, Meda; Pişkin, İlksin; Yöney, Aysel

doi:10.1111/j.1442-200x.2009.02859.x

Cited by 18 publications

(30 citation statements)

References 20 publications

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“…Two case-control studies, Arslan et al and Contencin and Nancy, found a statistically significant increase in reflux in patients with recurrent croup, from a symptomatic standpoint and with esophageal and pharyngeal pH data. 4,11 However, regardless of study design, this association does not establish causality. Patients treated with reflux medications appear to demonstrate a reduced incidence of croup or croup symptoms, and these studies are less heterogeneous, meaning that the combined results are more conclusive.…”

Section: Discussionmentioning

confidence: 94%

“…Of the 15 articles included in this review, 12 are cross-sectional studies that describe the prevalence of reflux in patients with recurrent croup. 3,4,6,[9][10][11][12][13][14][15][16][17][18][19] These are summarized in Table I. The reported prevalence of GERD in these studies ranges from 5% (Jabbour et al) to 87% (Hoa et al), and studies that used direct laryngobronchoscopy findings to define GERD tended to report higher prevalence than those that relied on clinical presentation and history.…”

Section: Resultsmentioning

confidence: 99%

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The Relationship between Croup and Gastroesophageal Reflux: A Systematic Review and Meta‐Analysis

Coughran

Balakrishnan

et al. 2020

The Laryngoscope

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Objective The mechanism by which recurrent croup occurs is unknown. Gastroesophageal reflux is commonly implicated, although this relationship is only loosely documented. We conducted a systematic review with a meta‐analysis component to evaluate the relationship between recurrent croup and gastroesophageal reflux disease (GERD), and to assess for evidence of improvement in croup symptoms when treated. Style Design Systematic Review and Meta Analysis. Methods We searched five separate databases. Studies were included if they discussed the relationship between croup and GERD in children, >5 subjects, and available in English. Literature retrieved was assessed according to pre‐specified criteria. Retrieved articles were reviewed by two independent authors and decisions mediated by a third author. If there was a difference of opinion after first review, a second review was performed to obtain consensus. Heterogeneity was calculated and summarized in forest plots. Results Of 346 initial records, 15 met inclusion criteria. These were two retrospective cohort and 13 cross‐sectional studies. Thirteen of 15 articles support an association between recurrent croup and GERD. Although heterogeneity is high among studies that reported prevalence of GERD, there is less uncertainty in results for improvement to recurrent croup after GERD treatment. Most studies lacked a control group and all carry a moderate‐to‐high risk of bias. Conclusion There is limited evidence linking GERD to recurrent croup; Further research is needed to assess for causality as most studies are retrospective, lack a control group, and have a study design exposing them to bias. Patients treated with reflux medication appear to demonstrate a reduced incidence of croup symptoms. Level of Evidence 1 Laryngoscope, 131:209–217, 2021

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Section: Discussionmentioning

confidence: 94%

Section: Resultsmentioning

confidence: 99%

The Relationship between Croup and Gastroesophageal Reflux: A Systematic Review and Meta‐Analysis

Coughran

Balakrishnan

et al. 2020

The Laryngoscope

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“…These sur veys suggest that further observation of children with recurrent subglottic laryngitis is necessary to potentially screen for asthma [18]. The possi ble mechanisms that explain the increased risk of asthma in children with a history of acute subglottic laryngitis include a smaller diameter of the airways (both central and peripheral), more frequent atopy, gastroesophageal reflux, bronchial hyperresponsiveness and common CD14 gene polymorphisms [19][20][21][22]. In adulthood, cases of acute subglottic laryngitis are very rare [23].…”

Section: Epidemiologymentioning

confidence: 99%

Acute Subglottic Laryngitis. Etiology, Epidemiology, Pathogenesis and Clinical Picture

Mazurek

Bręborowicz

Doniec³

et al. 2019

Advances in Respiratory Medicine

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In about 3% of children, viral infections of the airways that develop in early childhood lead to narrowing of the laryngeal lumen in the subglottic region resulting in symptoms such as hoarseness, a barking cough, stridor, and dyspnea. These infections may eventually cause respiratory failure. The disease is often called acute subglottic laryngitis (ASL). Terms such as pseudocroup, croup syndrome, acute obstructive laryngitis and spasmodic croup are used interchangeably when referencing this disease. Although the differential diagnosis should include other rare diseases such as epiglottitis, diphtheria, fibrinous laryngitis and bacterial tracheobronchitis, the diagnosis of ASL should always be made on the basis of clinical criteria.

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“…Whereas there is no definitive definition, atypical croup is usually described as frequently recurrent croup episodes often occurring in children outside the expected age of presentation. Atypical croup is less associated with viral entities and more commonly described as an allergic or inflammatory response . Whereas reports suggest that anywhere from 25% to 100% of these children have other airway lesions, there are some children who continue to suffer from atypical croup despite having no evidence of airway anomalies.…”

Section: Introductionmentioning

confidence: 99%

Subglottic cauterization: An atypical approach for atypical croup

Wilcox

Rutter

2019

The Laryngoscope

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Evaluation of allergic sensitization and gastroesophageal reflux disease in children with recurrent croup

Abstract: GER and atopy should be investigated in patients with recurrent spasmodic croup. Recurrent croup is a non-specific manifestation of atopy. Patients with atopy should be followed closely for developing bronchial asthma.

Cited by 18 publications

References 20 publications

The Relationship between Croup and Gastroesophageal Reflux: A Systematic Review and Meta‐Analysis

The Relationship between Croup and Gastroesophageal Reflux: A Systematic Review and Meta‐Analysis

Acute Subglottic Laryngitis. Etiology, Epidemiology, Pathogenesis and Clinical Picture

Subglottic cauterization: An atypical approach for atypical croup

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