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LINX(®), a novel treatment for patients with refractory asthma complicated by gastroesophageal reflux disease: a case report
BACKGROUND: Gastroesophageal reflux disease is one of the most common comorbidities in patients with asthma. Gastroesophageal reflux disease can be linked to difficult-to-control asthma. Current management includes gastric acid suppression therapy and surgical antireflux procedures. The LINX® proced...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4878099/ https://www.ncbi.nlm.nih.gov/pubmed/27220906 http://dx.doi.org/10.1186/s13256-016-0887-6 |
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author | Sriratanaviriyakul, Narin Kivler, Celeste Vidovszky, Tamas J. Yoneda, Ken Y. Kenyon, Nicholas J. Murin, Susan Louie, Samuel |
author_facet | Sriratanaviriyakul, Narin Kivler, Celeste Vidovszky, Tamas J. Yoneda, Ken Y. Kenyon, Nicholas J. Murin, Susan Louie, Samuel |
author_sort | Sriratanaviriyakul, Narin |
collection | PubMed |
description | BACKGROUND: Gastroesophageal reflux disease is one of the most common comorbidities in patients with asthma. Gastroesophageal reflux disease can be linked to difficult-to-control asthma. Current management includes gastric acid suppression therapy and surgical antireflux procedures. The LINX® procedure is a novel surgical treatment for patients with gastroesophageal reflux disease refractory to medical therapy. To the best of our knowledge, we report the first case of successful treatment of refractory asthma secondary to gastroesophageal reflux disease using the LINX® procedure. CASE PRESENTATION: Our patient was a 22-year-old white woman who met the American Thoracic Society criteria for refractory asthma that had remained poorly controlled for 5 years despite progressive escalation to step 6 treatment as recommended by National Institutes of Health-National Asthma Education and Prevention Program guidelines, including high-dose oral corticosteroids, high-dose inhaled corticosteroid plus long-acting β(2)-agonist, leukotriene receptor antagonist, and monthly omalizumab. Separate trials with azithromycin therapy and roflumilast did not improve her asthma control, nor did bronchial thermoplasty help. Additional consultations with two other university health systems left the patient with few treatment options for asthma, which included cyclophosphamide. Instead, the patient underwent a LINX® procedure after failure of maximal medical therapy for gastroesophageal reflux disease with the additional aim of improving asthma control. After she underwent LINX® treatment, her asthma improved dramatically and was no longer refractory. She had normal exhaled nitric oxide levels and loss of peripheral eosinophilia after LINX® treatment. Prednisone was discontinued without loss of asthma control. The only immediate adverse effects due to the LINX® procedure were bloating, nausea, and vomiting. CONCLUSIONS: LINX® is a viable alternative to the Nissen fundoplication procedure for the treatment of patients with gastroesophageal reflux disease and poorly controlled concomitant refractory asthma. |
format | Online Article Text |
id | pubmed-4878099 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-48780992016-05-25 LINX(®), a novel treatment for patients with refractory asthma complicated by gastroesophageal reflux disease: a case report Sriratanaviriyakul, Narin Kivler, Celeste Vidovszky, Tamas J. Yoneda, Ken Y. Kenyon, Nicholas J. Murin, Susan Louie, Samuel J Med Case Rep Case Report BACKGROUND: Gastroesophageal reflux disease is one of the most common comorbidities in patients with asthma. Gastroesophageal reflux disease can be linked to difficult-to-control asthma. Current management includes gastric acid suppression therapy and surgical antireflux procedures. The LINX® procedure is a novel surgical treatment for patients with gastroesophageal reflux disease refractory to medical therapy. To the best of our knowledge, we report the first case of successful treatment of refractory asthma secondary to gastroesophageal reflux disease using the LINX® procedure. CASE PRESENTATION: Our patient was a 22-year-old white woman who met the American Thoracic Society criteria for refractory asthma that had remained poorly controlled for 5 years despite progressive escalation to step 6 treatment as recommended by National Institutes of Health-National Asthma Education and Prevention Program guidelines, including high-dose oral corticosteroids, high-dose inhaled corticosteroid plus long-acting β(2)-agonist, leukotriene receptor antagonist, and monthly omalizumab. Separate trials with azithromycin therapy and roflumilast did not improve her asthma control, nor did bronchial thermoplasty help. Additional consultations with two other university health systems left the patient with few treatment options for asthma, which included cyclophosphamide. Instead, the patient underwent a LINX® procedure after failure of maximal medical therapy for gastroesophageal reflux disease with the additional aim of improving asthma control. After she underwent LINX® treatment, her asthma improved dramatically and was no longer refractory. She had normal exhaled nitric oxide levels and loss of peripheral eosinophilia after LINX® treatment. Prednisone was discontinued without loss of asthma control. The only immediate adverse effects due to the LINX® procedure were bloating, nausea, and vomiting. CONCLUSIONS: LINX® is a viable alternative to the Nissen fundoplication procedure for the treatment of patients with gastroesophageal reflux disease and poorly controlled concomitant refractory asthma. BioMed Central 2016-05-24 /pmc/articles/PMC4878099/ /pubmed/27220906 http://dx.doi.org/10.1186/s13256-016-0887-6 Text en © Sriratanaviriyakul et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Case Report Sriratanaviriyakul, Narin Kivler, Celeste Vidovszky, Tamas J. Yoneda, Ken Y. Kenyon, Nicholas J. Murin, Susan Louie, Samuel LINX(®), a novel treatment for patients with refractory asthma complicated by gastroesophageal reflux disease: a case report |
title | LINX(®), a novel treatment for patients with refractory asthma complicated by gastroesophageal reflux disease: a case report |
title_full | LINX(®), a novel treatment for patients with refractory asthma complicated by gastroesophageal reflux disease: a case report |
title_fullStr | LINX(®), a novel treatment for patients with refractory asthma complicated by gastroesophageal reflux disease: a case report |
title_full_unstemmed | LINX(®), a novel treatment for patients with refractory asthma complicated by gastroesophageal reflux disease: a case report |
title_short | LINX(®), a novel treatment for patients with refractory asthma complicated by gastroesophageal reflux disease: a case report |
title_sort | linx(®), a novel treatment for patients with refractory asthma complicated by gastroesophageal reflux disease: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4878099/ https://www.ncbi.nlm.nih.gov/pubmed/27220906 http://dx.doi.org/10.1186/s13256-016-0887-6 |
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