Cecilia Mantegazza1*, Giulia Rendo1, Marta Pagano1, Salvatore Zirpoli2, Milena Meroni3, Luciano Maestri3, Andrea Farolfi4, Silvia Salvatore5 and Gianvincenzo Zuccotti1
1Department of Pediatrics, "Vittore Buzzi" Children's Hospital, University of Milan, Italy
2Department of Radiology, "Vittore Buzzi" Children's Hospital, University of Milan, Italy
3Department of Surgical, "Vittore Buzzi" Children's Hospital, University of Milan, Italy
4Department of Pneumology, "Vittore Buzzi" Children's Hospital, University of Milan, Italy
5Department of Pediatrics, Filippo Del Ponte Hospital, University of Insubria, Italy
To characterize Gastroesophageal Reflux (GER) by multiple esophageal pH-impedance (MII-pH) in children with idiopathic Bronchiectasis (BC); to assess its relation with respiratory function through spirometry; to analyze the accuracy of a morpho-functional High-Resolution Computed Tomography (HRCT) scoring system in predicting MIIpH results. Methods: MII-pH parameters in children with respiratory symptoms, with and without BC were compared. In children with BC spirometry was performed and HRCT score was calculated by evaluating in each lung lobe: 1. bronchiectasis-peribronchial wall thickening, 2. mucous plugging, 3. abscess-sacculations, 4. consolidations, 5. others. HRCT score was related to MII-pH results. HRCT score accuracy in predicting pathological MII-pH was evaluated by ROC curve. Results: Twenty children with BC (mean age 8.25 ± 5 years, 12 males) and 20 without BC (mean age 8 ± 5.1 years; p: 0.2918, 15 males p: 0.1577) were enrolled. No significant differences were found in any MII-pH parameter between the two groups. Among BC children, 7/20 had a pathological MIIpH and didn’t show difference in respiratory function compared to those without GER. There were no significant correlation between HRCT score and MII-pH parameters but a direct (not significant) correlation with RI (r=0.240 p=0.307), acid refluxes (r=0.022 p=0.925) and SI/SAP (r=0.041 p=0.865). The mean value of the HRCT score in children with BC with pathological MIIpH was higher than in the ones with normal MII-pH (6.571 vs. 4.846, p=0.0929). The Area under the Curve was 0.736. A HRCT score of 4.5 and 7.5 were associated with a negative predictive value of 86.5% and a positive predictive value of 75% respectively. Conclusion: Children with idiopathic BC had no distinct GER features. HRCT scoring system showed a moderate accuracy in predicting MII-pH results and a value ≤ 4.5 is rarely associated with a pathological MII-pH.
Children; Bronchiectasis; pH-impedance; MII-pH; Gastroesophageal reflux disease; High-resolution computed tomography
Mantegazza C, Rendo G, Pagano M, Zirpoli S, Meroni M, Maestri L, et al. Gastroesophageal Re lux in Children with Idiopathic Bronchiectasis: A Pilot Study. Clin Surg. 2022; 7: 3559..