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

Coughran, Alanna; Balakrishnan, Karthik; Ma, Yifei; Vaezeafshar, Reza; Capdarest–Arest, Nicole; Hamdi, Osama; Sidell, Douglas

doi:10.1002/lary.28544

Cited by 6 publications

(5 citation statements)

References 24 publications

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“…13,15,16,[18][19][20][21][22][23][24] For example, a high incidence of gastroesophageal reflux disease has been reported in patients diagnosed with recurrent croup, with many of these patients experiencing symptom resolution with antireflux medication. 16,25 In our study, a diagnosis of gastroesophageal reflux disease was reported in 27 (23.7%) patients. Reflux-associated laryngotracheal mucosal irritation may cause croup-like respiratory symptoms.…”

Section: Symptom Characteristics Of Recurrent Croupmentioning

confidence: 50%

Clinical Presentation of Pediatric Recurrent Croup: Implications for Diagnosis

Franks

Espahbodi

et al. 2023

Clin Pediatr (Phila)

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Recurrent croup is a common clinical entity afflicting the pediatric population, but is not well-characterized in the literature. We describe the largest series of recurrent croup in North America from a single tertiary care academic center, and differentiate subpopulations based on demographic characteristics and clinical presentation. We identified 114 patients for inclusion. Common symptoms included barky cough (86.0%) and inspiratory stridor (60.5%). Many (26.3%) experienced full symptom resolution within a day, and 41.2% reported onset of symptoms at any time of the day. Male patients had a higher number of prior croup episodes at presentation compared with female patients (mean of 9.8 ± 8.0 in males vs 6.6 ± 4.8 in females, P = .03). On multivariate regression, racial/ethnic minority patients were at higher risk for dyspnea (odds ratio [OR]: 58.6; 95% confidence interval [CI]: 7.2-475.4) and upper respiratory infection prodrome (OR: 7.6; 95% CI: 1.6-35.3) compared with non-Hispanic white patients.

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Section: Symptom Characteristics Of Recurrent Croupmentioning

confidence: 50%

Clinical Presentation of Pediatric Recurrent Croup: Implications for Diagnosis

Franks

Espahbodi

et al. 2023

Clin Pediatr (Phila)

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“…The rate of positive airway findings in children undergoing DLB for RC symptoms ranges between 33%-55% in different studies 23,24,30 have been associated with GERD include erythema and edema of the arytenoids or posterior glottis or narrowing or strictures of the esophagus. 33,34 It is proposed that aspiration of refluxed acid into the trachea and upper airway causes mucosal sloughing and edema that makes the patient more susceptible to RC symptoms.…”

Section: Airway Findingsmentioning

confidence: 99%

“…The rate of positive airway findings in children undergoing DLB for RC symptoms ranges between 33%–55% in different studies 23,24,30 Among these, various grades of subglottic narrowing/stenosis and clinical findings suggestive of GERD are the leading abnormal findings. Sub‐glottic stenosis is generally Grade I or II (Myer‐Cotton grading system based on endotracheal tube size).…”

Section: Role Of Triple Endoscopy In CCmentioning

confidence: 99%

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A multi‐disciplinary approach to chronic cough in children

Mukerji

Yenduri

Chiou

et al. 2022

Laryngoscope Investig Oto

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Objectives (1) To highlight the important causes of chronic and recurrent cough in children. (2) To discuss multidisciplinary approach to management of chronic/recurrent pediatric cough. Methods Review of scholarly articles, guidelines, expert panels via PubMed and Google Scholar. Conclusion Chronic cough (CC) in children is mainly attributed to persistent bacterial bronchitis, asthma, nonspecific cough, and gastroesophageal reflux disease (GERD) symptoms. A multi‐disciplinary approach is cost‐effective and aids with earlier diagnosis and appropriate treatment. Congenital or acquired narrowing of the subglottis is the leading ENT cause for recurrent croup (RC) in children. Laryngeal cleft‐type 1 is commonly seen in children with recurrent aspiration and CC. Children are usually referred to pulmonologists for wet cough not responding to treatment. Eosinophilic esophagitis (EoE) and GERD should be considered in the differential diagnosis of CC in children with both respiratory symptoms and failure to thrive. Level of Evidence: 2a

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“…Причини виникнення рекурентних епізодів ГОЛ можуть бути різними: аномалії розвитку гортані, інтубація трахеї в анамнезі, гастро езофагеальний рефлюкс, первинне тубінфіку вання, бронхіальна астма, інші алергічні захво рювання, імунологічні порушення, генетична схильність, рецидивні ГРІ тощо [4,5,11,16,22,25]. Зазначені чинники ризику можуть також призводити до атипового перебігу крупу.…”

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Recurrent episodes of viral croup in children: potential causes and approaches to its prevention

Romanko¹

2021

MPU

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Viral croup is one of the most common causes of upper respiratory tract obstruction in children under 6 years of age. Frequent acute respiratory infections (ARIs) and a burdened history of allergies might be triggers for recurrent episodes of viral croup. Purpose — to study vitamin D status in infants with viral croup and the efficacy of cholecalciferol supplements for recurrent episodes prevention. Materials and methods. Hospital(based survey included 128 children aged 4–36 months with viral croup. Vitamin D status was evaluated by measuring serum 25 (OH) D levels. Control studies were performed after 12 weeks. A prospective follow(up study lasted for three years. Results. 32.8±4.1% (42/128) of hospitalized children with viral croup had a history of frequent episodes of ARIs (>6 episodes per year). Recurrent episodes of viral croup were more frequent in children with a burdened history of allergies compared to those who did not have allergies — 46.4±9.4% (13/28) vs. 23.0±4.2% (23/100) (р=0.028). At the time of enrollment, 47.6±4.4% (61/128) of children had optimal concentration of 25 (ОН) D (30–100 ng/ml). Serum 25 (OH) D levels in children who regularly received supplements were 33.5 ng/ml (27.2–44.5) at the time of control. Patients with a level of 25 (OH) D>30 ng/ml were less likely to have recurrent ARIs (0/29) during the observation period compared to those with a level of 25 (OH) D 20–30 ng/ml (25.0±10.8%, 4/16) (p=0.023). In children with a concentration of 25 (OH) D>30 ng/ml, the risks for recurrent episodes of viral croup in the future were 9 times lower (OR=9.00; 95% CI: 1.55–52.27), and the risks of more mild viral croup course were 11.4 times lower (OR=11.40; 95% CI: 1.20–108.29). Conclusions. Insufficient levels of vitamin D were recorded in 46.1±4.4% of children with viral croup. When the concentration of 25 (OH) D in serum increased to >30 ng/ml, the frequency of recurrent ARIs decreased (p=0.023); the risks for recurrent episodes of viral croup decreased, as well as the risks of more severe viral croup course. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the author. Key words: recurrent episodes, viral croup, children, causes, prevention.

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

Cited by 6 publications

References 24 publications

Clinical Presentation of Pediatric Recurrent Croup: Implications for Diagnosis

Clinical Presentation of Pediatric Recurrent Croup: Implications for Diagnosis

A multi‐disciplinary approach to chronic cough in children

Recurrent episodes of viral croup in children: potential causes and approaches to its prevention

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