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Exposures and coexisting conditions in pediatric nodular tracheobronchitis
Lauren M C Grant1, Emily Collins2, Karen B Zur3,4
1Division of Pulmonary and Sleep Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Pediatric Pulmonology
|July 20, 2024
Summary
Nodular tracheobronchitis in children often coexists with conditions like GERD and dysphagia. Further evaluation for these factors is recommended when diagnosing this airway condition.
Area of Science:
- Pediatric Pulmonology
- Pediatric Gastroenterology
Background:
- Nodular tracheobronchitis is a condition affecting children's airways.
- Understanding coexisting conditions is crucial for effective management.
Purpose of the Study:
- To investigate the prevalence of coexisting conditions and exposures in children diagnosed with nodular tracheobronchitis.
- To identify potential contributing factors in the pathophysiology of the condition.
Main Methods:
- Retrospective review of 100 children diagnosed with nodular tracheobronchitis via flexible bronchoscopy (2012-2023).
- Analysis of coexisting diagnoses, bronchoalveolar lavage (BAL) results, and gastrointestinal evaluations (EGD, VFSS, impedance/pH testing).
Main Results:
- High prevalence of gastroesophageal reflux disease (50%), dysphagia/aspiration (40%), asthma (30%), and eosinophilic esophagitis (12%).
- BAL showed neutrophilic inflammation (63%) associated with positive bacterial cultures (52%) and viral PCR (57%).
- Gastrointestinal evaluations revealed abnormal swallowing studies (60%) and significant reflux indices.
Conclusions:
- Bacterial/viral infections, GERD, dysphagia/aspiration, and EOE are potential contributors to nodular tracheobronchitis.
- Further investigation for these conditions is recommended upon diagnosis of nodular tracheobronchitis.
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