Pediatric patients with chronic cough and recurrent croup: The case for a multidisciplinary approach
Publication Date
2015
Journal Title
Int J Pediatr Otorhinolaryngol
Abstract
Objective: To evaluate the results of our multidisciplinary approach to recurrent croup and chronic cough. Methods: Retrospective chart review of all patients with recurrent croup and chronic cough managed at a tertiary care children's hospital by our Comprehensive Airway, Respiratory, and Esophageal (CARE) Team. Charts were reviewed for all patients who carried a diagnosis of recurrent croup or chronic cough. Patients were excluded if they did not receive a full workup, including micro-direct laryngoscopy, flexible and/or rigid bronchoscopy, bronchioalveolar lavage (BAL), and upper endoscopy with biopsies. We reviewed the records for the presence of gastrointestinal complaints, abdominal pain and failure to thrive (FTT) and compared the children with documented esophagitis to the remaining children. Results: Forty patients met inclusion criteria. 53% had airway abnormalities; the most common was tracheomalacia, followed by enlarged adenoids. 38% had esophagitis (group 1) while 62% had normal esophageal biopsies (group 2). Among the children in group 1, 27% met criteria for eosinophilic esophagitis (>15 eosinophils per high powered field). There was no significant difference between groups 1 and 2 based on the presence of gastrointestinal complaints, abdominal pain and/or FTT (p > 0.05). There was no significant difference between the groups based on the location or presence of an airway abnormality (p > 0.05). Conclusions: Children with recurrent croup and chronic cough may benefit from a multidisciplinary approach to management. Our CARE Team approach led to a specific diagnosis in almost 95% of patients. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
Volume Number
79
Issue Number
5
Pages
749-752
Document Type
Article
EPub Date
2015/03/31
Status
Faculty
Facility
School of Medicine
Primary Department
Pediatrics
Additional Departments
Otolaryngology
PMID
DOI
10.1016/j.ijporl.2015.03.007