Pulmonary Symptoms With GERD in Infants May Increase Asthma Risk

Drooling infant, child, pediatric
Drooling infant, child, pediatric
Infants who presented with pulmonary symptoms when diagnosed with gastroesophageal reflux disease had a higher incidence of early onset asthma compared with infants who did not have pulmonary symptoms.

This article is part of Pulmonology Advisor‘s coverage of the CHEST 2018 meeting, taking place in San Antonio, Texas. Our staff will report on medical research related to COPD, critical care medicine, and more conducted by experts in the field. Check back regularly for more news from CHEST 2018.

SAN ANTONIO — Cough was the most prevalent pulmonary symptom in infants with gastroesophageal reflux disease (GERD), according to findings presented at the CHEST Annual Meeting, held October 6-10, in San Antonio, Texas.

Presenting author Endy Dominguez Silveyra, MD, noted that a previous study demonstrated a link between preexisting GERD and higher severity of bronchiolitis in infants. However, there is limited research available to understand the association between GERD and pulmonary symptoms or reactive airway disease in infants.

Dr Silveyra and colleagues at NYU Winthrop Hospital in Mineola, New York, conducted a retrospective review of 262 patients with GERD (ages 0-12 months). A total of 138 (53%) patients had pulmonary symptoms and 124 (47%) did not have pulmonary symptoms. Cough was the most prevalent symptom at 47% vs wheezing or breathing difficulty. Although there was no significant relation noted between family history of allergy and GERD, 84% of patients with eczema had pulmonary symptoms vs 48% of patients without eczema (P <.001).

Patients with pulmonary symptoms also had a higher incidence of early onset asthma (63%; median age at diagnosis, 8.4 months) and use of albuterol (92%) than patients without pulmonary symptoms (P =.01).

Cough was the predominant symptom compared with wheezing or shortness of breath, which can help distinguish GERD from pulmonary disease in patients with overlapping symptoms. In addition, the presence of eczema was strongly associated with pulmonary symptoms at GERD diagnosis.

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Because these results indicate an increased risk for asthma developing at a younger age, the researchers urged diagnosing and managing GERD as early as possible to prevent long-term pulmonary complications.

Dr Silveyra stated that these findings are the first part of an ongoing study and that these patients will be followed as they grow older.

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Silveyra ED, Farah D, Pirzada M. Prevalence of pulmonary symptoms in infants with gastroesophageal reflux disease (GERD). Presented at: CHEST Annual Meeting 2018; October 6-10, 2018; San Antonio, TX.