Twenty-four hour intraesophageal pH monitoring in children and adolescentswith scleroderma and mixed connective tissue disease

Objective. To investigate esophageal dysmotility and gastroesophageal reflu x, which are important, but often occult features of gastrointestinal (GI) involvement in children and adolescents with mixed connective tissue diseas e (MCTD) and scleroderma. Methods. We carried out intraesophaeeal 24 h pH monitoring of 14 patients w ith scleroderma and MCTD. Results. We observed an elevated reflux index in 64% of the patients. An in creased number of reflux events was found in 85%. Reflux events > 5 min wer e noted in 50% of the patients, which is indicative of possible development of esophagitis. Only 3 patients presented clinical symptoms. Four of 5 pat ients with localized scleroderma revealed a pathological reflux index. We f ound no relationship between gastroesophageal reflux, age of patients, dura tion of disease, and Raynaud's phenomenon. Conclusion. GI involvement in children with scleroderma or MCTD is more fre quent than clinical symptoms indicate. An active diagnostic investigation f or GI dysmotility and gastroesophageal reflux is necessary to detect these complications.