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Etiology of 19 infants with apparent life-threatening events: relationship between apnea and esophageal dysfunction
K Tsukada1, N Kosuge, M Hosokawa
1Department of Pediatrics, Tokyo Women's Medical College, Daini Hospital, Japan.
Insights
Apparent life-threatening events (ALTE) in infants can stem from various causes, including gastroesophageal reflux (GER). This study found GER and esophageal dysmotility are significant potential triggers for ALTE in infants.
Area of Science:
- Pediatrics
- Gastroenterology
- Neonatal Medicine
Background:
- Apparent life-threatening events (ALTE) in infants present a diagnostic challenge, with multiple underlying etiologies.
- Gastroesophageal reflux (GER) and esophageal dysmotility are suspected contributors to ALTE but require further investigation.
Observation:
- A cohort of 19 infants presenting with ALTE (mean age 4.3 months) between 1986 and 1991 underwent comprehensive etiological investigation.
- Diagnostic methods included laboratory data analysis, radiological studies, and esophageal function tests.
Findings:
- Gastroesophageal reflux (GER) was diagnosed in 6 of 19 infants.
- Other identified causes included pertussis (5), upper respiratory infection (3), vagotonia-like condition with esophageal dysfunction (2), laryngostenosis with cerebral palsy (2), choking (2), and epilepsy (1).
- Two cases involved a combination of GER with pertussis or vagotonia-like condition.
Implications:
- These findings suggest that GER and esophageal dysmotility are significant potential causes of ALTE in infants.
- Further research is warranted to precisely determine the frequency with which GER and esophageal dysmotility contribute to ALTE.
Abstract:
There are various identifiable diseases or conditions that can cause apparent life-threatening events (ALTE; e.g. gastroesophageal reflux (GER) and seizures). Nineteen infants with ALTE (mean age: 4.3 months) were brought to our hospital between June 1986 and August 1991. The causes of these ALTE were investigated. Analysis of laboratory data, radiological studies and esophageal function tests led to the diagnosis of GER in six of 19 infants; pertussis in five; upper respiratory infection in three; vagotonia-like condition with esophageal dysfunction in two; laryngostenosis with cerebral palsy in two; choking on food or drink in two; and epilepsy in one infant. Two cases (one case of pertussis and one of vagotonia-like condition) were associated with GER. Some of the cases demonstrate that ALTE in infants may be induced by GER or some esophageal dysmotility. Further studies of ALTE are needed to ascertain how frequently GER or esophageal dysmotility is responsible for ALTE.