Naslov
Recognising Atypical Manifestations of GERD: Chronic Cough, Asthma

Autori
Perić, Marija ; Jurčić, Petra

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, ostalo

Izvornik
Toraks 2014 / - , 2014, 23-23

Skup
4th Congress of the Croatian Thoracic Society

Mjesto i datum
Zagreb, Hrvatska, 04.06.2014. - 07.06.2014

Vrsta sudjelovanja
Poster

Vrsta recenzije
Domaća recenzija

Ključne riječi
asthma ; cough ; GERD

Sažetak
In the last decade, numerous pathophysiological mechanisms have been discovered that might explain the link between gastroesophageal reflux disease (GERD) and asthma, most commonly described as microaspiration, vagal reflex and increased reactivity of the airways. Untreated GERD is a common cause of poor control of asthma in children treated that are inhaled corticosteroids. The patient I.S., 18 years of age, was born as the second of three children from an orderly pregnancy, exhibiting orderly growth and development, regularly vaccinated, free of identified allergies. The family history is negative for atopic illnesses. Four years ago, occasional attacks of dry irritated coughing worsened over the past 16 months resulting in an impaired quality of life. The coughing occurs both day and night, in the intervals of 15 minutes, repeating about half to one hour. Allergy test, IgE 38.4 U/ml, histamine 5 × 5 mm, DP 2 × 3 mm, hairs 2 × 2 mm, feathers 1 × 2 mm, pollen +/-. The nasal swabs revealed eosinophils. Spirometry was orderly, orderly findings for lung X-rays, PPD without irregularities. A conducted pH metry of the oesophagus showed to be orderly. The patient had a pulmonary examination IgA 1.6 U/ml , IgG 7.2 U/ml , IgM 2.0 U/ml TSH 0.195 IU/ml, FeNO 18 ppb, spirometry findings proper. Due to the etiologically unexplained cause of the cough, based on the recommendations of the paediatrician, the pulmonologist sent the patient to a children's hospital for treatment. Atopic markers were neutral, skin prick test to allergens shoed up negative, PPD 20 × 16 mm, the interferon gamma was negative. Findings for the cytologic smear and high nasal FeNO provided evidence of chronic rhinosinusitis. Bronchologically visible hyperaemia and dyskinetic trachea, in both main bronchi there was a presence of a whitetish thickening. A 24-hour pH metry of the oesophagus showed severe gastroesophageal reflux. A gastroscopy examination after a year showed mild inflammation of the gastric mucosa and occasional erosion of the duodenal bulb, HP negative, due to which the continuation of therapy with pantoprazole was indicated. On account of the persistence of the cough and findings from the pulmonology tests, the paediatrician at the last check-up examination prescribed continued therapy with inhaled corticosteroids along with occasional use of salbutamol to which the patient responds well. Treatment of GERD in asthmatics has a significant impact on the quality of life, although it does not significantly affect the parameters of lung function.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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