Herbst’s Triad as a Manifestation of Gastroesophageal Reflux Disease

Abstract

The Herbst triad (HT) was described in 1976 by Herbst et al. (1) when detecting the association of iron deficiency anemia, hypoalbuminemia and clubbing in 3 children with hiatal hernia and severe esophagitis secondary to gastroesophageal reflux (GER). Although no chronic lung disease associated with reflux was demonstrated to justify the appearance of clubbing, these also disappeared after surgery (1). We present 2 children with HT that required surgical treatment due to lack of response to proton pump inhibitors.