Gastroesophageal Reflux Disease: An Etiology of Apparent Life Threatening Event in Early Infancy

Gastroesophageal reflux (GER) may lead to apparent life threatening event (ALTE) during childhood. Two months old girl presented with cough and cyanosis. Previous history, physical examination and routine blood tests were normal. Echocardiography revealed secundum atrial septal defect. Laryngos­copy displayed posterior laryngeal granulation tissue. 24 hour pH monitoring failed to detect pathological GER. Prolonged GER scintig­raphy revealed GER to the upper esophagus. Flexible fiberoptic bron­choscopy showed normal airway. Clinical findings disappeared with anti-GER treatment. Symptoms of GER may be complex and diagnosis may be difficult and it needs to be included in differential diagnosis of ALTE during early childhood.