Acta Peediatr 81: 635-6. 1992

CASE REPORT

Hoarseness in a child with gastroesophageal reflux PE Putnam and SR Orenstein Department of Pediatrics, Division of Pediatric Gastroenterology. University of Pittsburgh School of Medicine and Children's Hospital of Pittsburgh. Pennsylvania, USA

Putnam PE, Orenstein SR. Hoarseness in a child with gastroesophageal reflux. Acta Paediatr 1992;81:635-6. Stockholm. ISSN 0803-5253 Hoarseness is not generally appreciated to be a manifestation of pediatric gastroesophageal reflux. We describe a case in which treatment of yell-documented gastroesophageal reflux and esophagitis in a young girl with hoarseness and nocturnal cough led to resolution of these symptoms. Possible pathogenetic mechanisms and the difficulty in associating hoarseness with reflux by standard reflux testing are discussed. 0 Gastroesophageal reflux, hoarseness PE Putnam. Division of Pediatric Gastroenterology, Children's Hospital of Pittsburgh, 3705 Fijth Ave., Pittsburgh, PA 15213, USA

Hoarseness results when laryngeal function or anatomy colitis. She required intubation and mechanical ventilais altered in such a way as to prevent proper apposition tion for two weeks. Subsequent growth and developof the vocal cords for normal speech production. The ment were normal. voice becomes breathy and coarse and has diminished At age four years she developed night-time cough and ability to change volume and pitch. Laryngeal structural hoarseness associated with guaiac positive stools and a anomalies, infection, inflammation and trauma, as well decline in hemoglobin from 13 to 8 g/dl over a period of as neurogenic vocal cord dysfunction, can result in five months. Esophagogastro-duodenoscopy revealed hoarseness in children (I). proximal mucosal erythema and erosions; the distal Laryngeal inflammation can be produced in dogs by esophagus appeared normal, but biopsy revealed historepeated application of gastric secretions onto the vocal logic esophagitis. cords (2). In adult humans, laryngeal inflammation has Evaluation for gastroesophageal reflux by 24-h distal been reported in association with gastroesophageal esophageal pH monitoring disclosed increased reflux reflux (3-1 5). Stridor, which has been referred to as with pH < 4 for 9% of the total time (normal c 5%). laryngitis by some authors, has been reported in chil- Postprandial reflux was markedly increased (30% of the dren with gastroesophageal reflux (16-19). However, postprandial period with pH

Hoarseness in a child with gastroesophageal reflux.

Hoarseness is not generally appreciated to be a manifestation of pediatric gastroesophageal reflux. We describe a case in which treatment of well-docu...
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