Tekrarlayan Krup Tanısı Alan Çocukların Klinik Analizi

Abstract

Objective: Croup is a common disease in childhood, characterized by barking cough, hoarseness and inspiratory stridor. When symptoms show recurrent and/or persistent characteristics, attention must be paid in terms of other underlying diseases. Our aim is to retrospectively review the long term results of our follow-up patients with recurrent croup and to discuss the etiology and final diagnosis and treatment of this clinic description in the light of the literature. Material and Methods: This study included patients who had 3 or more croup attacks per year. The patients' frequency of attacks, triggers, persistancy of the complaints, atopic dermatitis, rhinitis symptoms, family history of atopy were derived from their medical records. Laboratory results [total eosinophil count, immunoglobulin E levels, skin prick test, gastroesophageal reflux (GER) tests] and treatments were evaluated. Results: 100 patients aged between 7 months and 14 years with recurrent croup diagnosis were evaluated. Of them, 77 were males, the median frequency of attacks was 4 (3- 10) times a year. In 17% of the patients, upper respiratory infection, in 24% spasmodic character, and in 59% both were determined as triggers. In 12% atopic dermatitis, in 42% rhinitis, in 36% atopy, in 33% GER disease, in 26% persistant croup, in 55% laryngotracheobronchitis (LTB) was detected. When laryngoscopy was performed on persistant croup patients, laryngomalacia was detected in 9% and GER findings were found in 15%. Of the patients, 48 were given inhaled steroid treatment, 7 were given reflux treatment and 26 received combination of inhaled steroid and reflux treatments, 8 were treated only during attacks. Conclusion: Recurrent croup is generally a benign clinical picture. Atopy, LTB and GER may be associated with recurrent croup. The patients who are detected to be atopic, and/or respond well to inhaled steroid must be closely monitored in terms of reactive airway disease. Persistent cases necessitate a multidisiplinary approach.