Gastroesophageal Reflux in Children With Idiopathic Bronchiectases: a Pilot Study

Abstract Background:The role of gastroesophageal reflux in bronchiectasis development is still object of discussion. We aimed to characterize gastroesophageal reflux (GER) in children with idiopathic bronchiectases (BC) and to analyse the relation with a morpho-functional High-Resolution Computed Tomography (HRCT) scoring systemMethods: Multiple esophageal impedance-pH (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: 20 children with BC and 20 without BC were enrolled. No significant differences were found in any MII-pH parameter between the two groups.Among BC children, 7/20 had a pathological MII-pH 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 MII-pH 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. Conclusions: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.Level of evidence:not properly applicable as it is a non-interventional diagnostic evaluation study.