title: Abnormal oral mucosal light reflectance in infantile hypertrophic pyloric stenosis.
abstract: OBJECTIVE
  Infantile hypertrophic pyloric stenosis (IHPS) is the most common condition requiring surgical intervention during the first weeks of life. The etiology of IHPS is unknown, although both neuronal nitric oxide synthase upregulation and an extracellular matrix abnormality are suspected. Familial predisposition is an important feature. Phenotypical markers of IHPS, such as hypoplasia or agenesis of the inferior labial frenulum, have been described. The authors tested the hypothesis that IHPS is associated with abnormal reflectance of the oral mucosa.
  
  
  METHODS
  Twenty-five children with surgically confirmed IHPS and 25 gender- and age-matched control subjects participated in the study. Reflectance of the lower gingival and vestibular oral mucosa in the optical spectrum was measured using an imaging spectrophotometer.
  
  
  RESULTS
  Patients with IHPS had significantly higher light reflectance values in the violet, blue, blue-green, green, yellow, and orange sections of the spectrum (all P values < 0.0001), with a maximum distance between group means at the 450-nm wavelength (t-value: 27.66, df = 48). A reflectance cutoff >5.26% at the 450-nm wavelength identified patients with IHPS with 100% sensitivity and 100% specificity.
  
  
  CONCLUSIONS
  This study reports a previously unrecognized mucosal reflectance abnormality of the oral mucosa in IHPS, thus offering a new, accurate, and noninvasive phenotypic marker for the condition.
authors.affiliation: Department of Odontostomatologic Sciences, University of Siena, Siena, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Parrini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Maggio
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Latini
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bianciardi
authors.forename: Laura
authors.initials: L
authors.lastname: Valdambrini
authors.forename: Claudio
authors.initials: C
authors.lastname: De Felice
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D016022:Case-Control Studies; D002675:Child, Preschool; D005109:Extracellular Matrix / Q000473:pathology; D005260:Female; D005881:Gingiva / Q000473:pathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008027:Light; D008297:Male; D009061:Mouth Mucosa / Q000473:pathology*; D010781:Photography; D046248:Pyloric Stenosis, Hypertrophic / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D013053:Spectrophotometry / Q000379:methods