The role of laryngopharyngeal reflux in the development of nasopharyngeal manifestations of GERD in preschoolers

Abstract

Purpose. To study the level of vitamin D and the levels of antimicrobial peptides in the blood of children suffering from gastroesophageal reflux disease with nasopharyngeal symptoms, to find out how they depend on the composition of refluxate in LFR and how they affect microbial colonization in the nasopharynx. Materials and methods. The clinical study was conducted on the basis of the ENT and the Gastroenterology Departments of the Municipal Non-Commercial Enterprise “City Children's Hospital no. 5" of Zaporizhia City Council. By clinical examination and pH monitoring in the esophagus, the following groups of children 3 to 6 years were established: the 1st group of 22 children with gastroesophageal reflux disease with nasopharyngeal signs, the 2nd group of 22 children with gastroesophageal reflux disease without nasopharyngeal signs. Children were assigned to 1st group on the basis of the presence of clinical manifestations that indicated like a high GER. For children with nasopharyngeal manifestations of GERD, there are not only complaints specific to GERD, as well as symptoms that may indicate LFR: cough after eating and morning hoarseness, redness of the larynx and swelling of the vocal cords.The control group (the 3rd group) consisted of 22 children without pathology from the gastrointestinal tract and ENT systems. The children were tested for the levels of 25(ОН)D3, 1,25(ОН)2D, vitamin D binding protein (DBP), αdefensins 1–3 and cathelicidins. Microbial contamination of the mucous membrane of the nasopharyngeal zone was carried out. As far as the distribution differed from normal one (p<0.05), the data are presented as median and inter-quartile ranges Me (Q25; Q75). The results were processed in Microsoft Excelfor Windows 4.0 and Statistica 6.0.