The Study of Allergic Skin Test in Patients with Globus Pharyngeus: A Preliminary Report
Pariyanan Jaruchinda MD*, Atik Saengsapawiriya MD**, Suriya Chakkaphak MD***, Suwin Somngeon MD*, Kaimuk Petsrikun BSc***
Affiliation : * Department of Otolaryngology, Phramongutklao College of Medicine, Bangkok, Thailand ** Department of Medicine, Phramongutklao College of Medicine, Bangkok, Thailand *** Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand
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.
Material and Method: 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%).
Conclusion : Due to high prevalence of positive skin test in globus pharyngeus patients, this symptom should
be considered as one of the atypical allergic manifestations.
Keywords : Conversion disorder, Gastroesophageal reflux, Skin tests
