GI scintiscan better as single test for GER detection in infant wheezers
MedWire News: Gastro-intestinal (GI) scintiscan performs better than 24-hour pH monitoring for detection of gastroesophageal reflux (GER) in infants with wheeze, show study results.
Wheezing is caused by asthma in the majority of infants, but it is important to remember that "all that wheezes is not asthma," say the researchers.
Soumya Patra (Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India) and colleagues compared the diagnostic ability of the GI scintiscan with 24-hour pH monitoring for detection of GER in 52 infants below the age of 2 years displaying symptoms of wheeze, but with normal or nearly normal chest X-ray results.
In total, 11 (48%) children had positive GER results, including. Eight (35%) with positive results from GI scintiscan only, and four (17%) with positive results from 24-hour pH monitoring alone.
Sensitivity, specificity, and positive and negative predictive value of the GI scintiscan technique were 58%, 85%, 69%, and 78%, respectively, and a corresponding 53%, 78%, 50%, and 81% for the 24-hour pH monitoring technique.
The team notes that agreement in positivity between the two tests was optimal in the 7-12 month age group. "The present study identified that GER is an important cause of recurrent wheezing among early childhood wheezers less than 2 years of age," write the authors in the Journal of Tropical Pediatrics.
They say that if only one test can be done, and if both the tests are available, then "gastroesophageal scintigraphy is the better test… as it has better sensitivity and specificity than 24 hour pH monitoring."
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By Helen Albert