The study of allergic skin test in patients with globus pharyngeus: a preliminary report.
BACKGROUND
Globus pharyngeus is the lump sensation in the throat associated with various conditions including somatoform disorder and gastroesophageal reflux disease. However, many patients with unrelated causes were found to respond to anti-allergic treatment.


OBJECTIVE
Determine the results of allergic skin test in globus pharyngeus patients who had unidentified causes.


METHODS
Fifty-four globus pharyngeus patients were enrolled and referred for complete physical examination, screening psychological status, videostroboscopy, and reflux finding score assessment. All patients including 38 controlled subjects underwent skin prick test and/or intradermal test. The globus patients who had positive test were recommended to have anti allergic treatment. Barium swallowing study, ambulatory double-probe pH monitoring, or plain film cervical spine was done in patients with negative skin tests and in non-response to medication.


RESULTS
There was statistically significant difference of positive skin test results between globus and the control group (77.8% vs. 28.6% OR = 13.12, p < 0.001). In positive skin test-globus group, globus symptom was improved in 64.3% after allergic treatment, which 85.2% had moderate and excellent improvement. In patients with negative skin test and non-response group show various conditions including gastroesophageal reflux disease (18.52%), abnormal esophageal manometry (40.74%), and myofascial pain syndrome (3.71%).


CONCLUSIONS
Due to high prevalence of positive skin test in globus pharyngeus patients, this symptom should be considered as one of the atypical allergic manifestations.
Department of Otolaryngology, Phramongutklao College of Medicine, Bangkok, Thailand. Jarujin@pmk.ac.th
Pariyanan
P
Jaruchinda
Atik
A
Saengsapawiriya
Suriya
S
Chakkaphak
Suwin
S
Somngeon
Kaimuk
K
Petsrikun
D000328:Adult; D000367:Age Factors; D001466:Barium Sulfate; D003291:Conversion Disorder / Q000209:etiology* / Q000523:psychology; D003680:Deglutition Disorders / Q000503:physiopathology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D006967:Hypersensitivity / Q000150:complications; D008297:Male; D008365:Manometry; D008875:Middle Aged; D010147:Pain Measurement; D010608:Pharyngeal Diseases / Q000209:etiology* / Q000503:physiopathology; D012737:Sex Factors; D012882:Skin Tests; D055815:Young Adult
D001466:Barium Sulfate