Hongmei Ding, Xianghuai Xu, Siwan Wen, Yiming Yu, Jing Pan, Cuiqin Shi, Ran Dong, Zhongmin Qiu, Li Yu
Background: The frequency distributions of the etiologies of chronic cough have changed over time. This study aimed to investigate the changing etiological frequency of chronic cough in a tertiary hospital in Shanghai, China, and to explore the clinical significance. Methods: Medical records of 1,311 patients with chronic cough who visit our hospital between January 2009 and December 2016 were retrospectively reviewed. The etiologies of chronic cough were identified according to a standardized step-by-step diagnostic protocol and the changes in the etiological frequency of chronic cough over the years were using the Chi-squared (χ2 ) test...
August 2019: Journal of Thoracic Disease
Xiaofang Liu, Xiangdong Wang, Xiujuan Yao, Yuhong Wang, Yongchang Sun, Luo Zhang
PURPOSE: Chronic cough in allergic rhinitis (AR) patients is common with multiple etiologies including cough variant asthma (CVA), non-asthmatic eosinophilic bronchitis (NAEB), gastroesophageal reflux-related cough (GERC), and upper airway cough syndrome (UACS). Practical indicators that distinguish these categories are lacking. We aimed to explore the diagnostic value of the fraction of exhaled nitric oxide (FeNO) and forced expiratory flow at 25% and 75% of pulmonary volume (FEF25-75 ) in specifically identifying CVA and NAEB in these patients...
November 2019: Allergy, Asthma & Immunology Research
Stephan Wieser
The Mysterious Cough - a Case-Based Proposal of Differential Diagnosis Abstract. Cough is a frequent complaint in the general practice. Avoidance of overdiagnosis and underdiagnosis is essential. In case of acute cough or subacute (<8 week duration), red flags indicate the need for further evaluation, otherwise it is mostly self-limiting. In case of chronic cough (>8 week duration) and normal baseline examination and after cessation of smoking and medication with ACE-I, cough-variant asthma, gastro-esophageal reflux disease and upper airway cough syndrome are the main causes and should be assessed and empirically treated in a systematic manner...
September 2019: Praxis
Xingmei Yu, Lingjun Kong, Wujun Jiang, Yinfang Dai, Yuqing Wang, Li Huang, Wei Luo, Kefang Lai, Chuangli Hao
Background: To comprehensively evaluate the etiology of chronic cough and the value of clinical feature in school age children in Suzhou, China. Methods: School-age (6-14 years) children newly referred with chronic cough (>4 weeks) were prospectively evaluated by utilizing a diagnostic algorithm in this study. Clinical features of different etiologies of chronic cough were also investigated. Results: In total, 118 patients were enrolled in the study...
July 2019: Journal of Thoracic Disease
Evan Li, J Morgan Knight, Yifan Wu, Amber Luong, Antony Rodriguez, Farrah Kheradmand, David B Corry
The allergic airway diseases, including chronic rhinosinusitis (CRS), asthma, allergic bronchopulmonary mycosis (ABPM) and many others, comprise a heterogeneous collection of inflammatory disorders affecting the upper and lower airways and lung parenchyma that represent the most common chronic diseases of humanity. In addition to their shared tissue tropism, the allergic airway diseases are characterized by a distinct pattern of inflammation involving the accumulation of eosinophils, type 2 macrophages, innate lymphoid cells type 2 (ILC2), IgE-secreting B cells, and T helper type 2 (Th2) cells in airway tissues, and the prominent production of type 2 cytokines including interleukin (IL-) 33, IL-4, IL-5, IL-13, and many others...
2019: Advances in Immunology
Li Long, Kefang Lai
Chronic cough is one of the most common complains for patients seeking medical attention in both general practice and respiratory specialist clinics. Cough variant asthma, eosinophilic bronchitis, upper airway cough syndrome, as well as gastro-esophageal reflux disease are common conditions associated with chronic cough, and cough variant asthma, eosinophilic bronchitis account for a higher proportion of patients with chronic cough in China than in Western countries. An older female predominance has been reported in most Western countries, which may be attributed to a higher cough reflex sensitivity in females, especially those post-menopausal females...
August 2019: Pulmonary Pharmacology & Therapeutics
Mao-Zhu Xu, Jing-Yue Liu, Zhou Fu
OBJECTIVE: To investigate the constitution of causes of chronic cough in children. METHODS: The clinical data of 202 children with chronic cough who were hospitalized in the Affiliated Children's Hospital of Chongqing Medical University from May 2015 to November 2017 were retrospectively analyzed. RESULTS: As for the causes of chronic cough in the 202 children, 81 (40.1%) had post-infection cough (PIC), 71 (35.1%) had cough variant asthma (CVA), 43 (21...
May 2019: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Laurent Guilleminault, Danielle Brouquières, Alain Didier
Cough is divided into two categories: acute cough lasting less than 3 weeks, and chronic cough lasting more than 8 weeks. Acute cough is usually triggered by a viral infection of the upper airways. Evidence of treatment effectiveness is low and management of acute cough is complex in clinical practice. Chronic cough is a common reason for consultation in medicine. The most frequent causes are upper airway diseases, gastroesophageal reflux disease, asthma, eosinophilic bronchitis, and drugs. Before investigation, smoking cessation and drug withdrawal must be achieved for 4 to 6 weeks...
March 26, 2019: La Presse Médicale
Fan Gao, Qing-Long Gu, Zi-Dong Jiang
BACKGROUND: In China, upper airway cough syndrome (UACS) is only less frequent than cough-variant asthma and accounts for 24.71% of chronic cough. This study aimed to determine the pathogenetic constituents and factors affecting UACS in children of different age groups, and to identify clinical clues for diagnosing UACS and a method for curative effect evaluation. METHODS: A total of 103 children with UACS whose chief complaint was chronic cough were studied from January to November 2013 at Children's Hospital, Capital Institute of Pediatrics...
March 20, 2019: Chinese Medical Journal
Ahmad Kantar, Manuela Seminara
Recently, there have been robust changes in our knowledge of the neurophysiology of cough and novel clinical etiologies. Specifically, cough hypersensitivity in adults and protracted bacterial bronchitis (PBB) in children have been increasingly investigated, and differences between chronic cough in children and adults have been widely reported. In young children, postinfectious cough, bronchiectasis, airway malacia, PBB, and asthma appear to be the main causes of cough; however, by adolescence, the causes of cough are more likely to become those common in adults, namely, gastroesophageal reflux, asthma, and upper airway syndrome...
June 2019: Pulmonary Pharmacology & Therapeutics
Andrew Bush, R Andres Floto
Bronchiectasis has historically been considered to be irreversible dilatation of the airways, but with modern imaging techniques it has been proposed that 'irreversible' be dropped from the definition. The upper limit of normal for the ratio of airway to arterial development increases with age, and a developmental perspective is essential. Bronchiectasis (and persistent bacterial bronchitis, PBB) is a descriptive term and not a diagnosis, and should be the start not the end of the patient's diagnostic journey...
November 2019: Respirology: Official Journal of the Asian Pacific Society of Respirology
Xin Chen, Wan-Sheng Peng, Lei Wang
This study aims to analyze the etiology of nonspecific chronic cough in children of 5 years and younger, in order to improve the diagnostic and treatment levels of pediatricians for nonspecific chronic cough in young children.The clinical data of 85 cases of children of 5 years old and below, who suffered from nonspecific chronic cough between the period of January 2015 and August 2016 were retrospectively analyzed.The etiology distribution of 85 cases of children with nonspecific chronic cough were as follows: 27 cases had cough variant asthma (31...
January 2019: Medicine (Baltimore)
Ji Young Hong, Joo-Hee Kim, Sunghoon Park, Yong Il Hwang, Ki-Suck Jung, Seung Hun Jang
Background/Aims: Inhaled corticosteroids (ICS) are a treatment of choice for eosinophilic airway diseases, but their efficacy for other causes of chronic cough is controversial. Methods: We conducted a prospective observational study to determine the ICS efficacy and clinical predictors of response to ICS in patients with upper airway cough syndrome (UACS) or unexplained chronic cough (UCC). Sixty-eight patients with UACS and 33 patients with UCC (duration of cough ≥ 8 weeks) were treated with ICS: 250 µg of fluticasone propionate or 400 µg of budesonide twice a day at physician's discretion...
December 13, 2018: Korean Journal of Internal Medicine
Peter V Dicpinigaitis, Oladunni Enilari, Krystal L Cleven
INTRODUCTION: Cough is induced by stimulation of structures innervated by the vagus nerve, including the upper and lower airways and distal esophagus. The Arnold nerve reflex describes cough resulting from stimulation of the external auditory canal, which is innervated by the auricular branch of the vagus. We have recently reported the increased prevalence of this reflex in adults, but not children, with chronic cough, relative to healthy adult and pediatric subjects. The prevalence of the Arnold nerve reflex in patients with pulmonary disease but without chronic cough has not been investigated previously...
November 13, 2018: Pulmonary Pharmacology & Therapeutics
Eva Polverino, Katerina Dimakou, John Hurst, Miguel-Angel Martinez-Garcia, Marc Miravitlles, Pierluigi Paggiaro, Michal Shteinberg, Stefano Aliberti, James D Chalmers
Bronchiectasis is a clinical and radiological diagnosis associated with cough, sputum production and recurrent respiratory infections. The clinical presentation inevitably overlaps with other respiratory disorders such as asthma and chronic obstructive pulmonary disease (COPD). In addition, 4-72% of patients with severe COPD are found to have radiological bronchiectasis on computed tomography, with similar frequencies (20-30%) now being reported in cohorts with severe or uncontrolled asthma. Co-diagnosis of bronchiectasis with another airway disease is associated with increased lung inflammation, frequent exacerbations, worse lung function and higher mortality...
September 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Ke-Lei Su, Ye-Qing Zhang
Chronic cough is a common clinical disease with complex etiology, which is easily misdiagnosed and mistreated. Chronic cough guideline has been developed based on the modern anatomical etiology classification, and it may improve the level of diagnosis and treatment. Common causes of chronic cough are as follows: cough variant asthma, upper airway cough syndrome, eosinophilic bronchitis, gastroesophageal reflux-related cough, post-infectious cough, etc. There is a long history and rich experience in treatment of cough in traditional Chinese medicine which is characterized by syndrome differentiation...
June 2018: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
Jeanne-Marie Perotin, Claire Launois, Maxime Dewolf, Antoine Dumazet, Sandra Dury, François Lebargy, Valérian Dormoy, Gaëtan Deslee
Chronic cough is a common complaint and a frequent cause of medical consultation. Its management can be difficult. We present here an overview of the current guidelines for the management of chronic cough. Different steps are detailed, including the initial research of an obvious etiology and alert signs that should lead to further investigation of underlying condition. The diagnosis of the most frequent causes: asthma, non-asthmatic eosinophilic bronchitis, gastroesophageal reflux disease and upper airway cough syndrome should be considered, assessed and treated accordingly...
2018: Therapeutics and Clinical Risk Management
Y Yildiz, M Igde
INTRODUCTION: Cough exceeding 3-8 weeks was defined as chronic cough in various guides. Asthma is the most common cause of chronic-specific cough. Causes other than asthma include prolonged bacterial bronchitis and upper airway cough syndrome (UACS). Nitric oxide (NO) causes vascular smooth muscle relaxation, bronchodilation, and oxidant effects via its metabolite, peroxynitrite. An increase in NO results in inflammation, vasodilatation, and bronchial edema. MATERIALS AND METHODS: The study group included 90 patients aged 6-17 years selected from individuals presenting to the Pediatric Immunology and Allergic Diseases Clinic with cough persisting for 4 weeks and 30 other patients representing to the control group...
January 2018: Nigerian Journal of Clinical Practice
Deniz Doğan Mülazımoğlu, Oya Kayacan
Chronic cough, that 10-38% outpatients have, is an important cause of morbidity and mortality. This symptom can be seen 3-40% of adult patients and reduces quality of life. 95% patients that cough chronically have one of these three diseases: upper airway cough syndrome, gastroesophageal reflux or asthma. In this review these three diseases and rare causes of chronic cough will be discussed and diagnostic steps will be explained.
September 2017: Tüberküloz Ve Toraks
Charlie Michaudet, John Malaty
Although chronic cough in adults (cough lasting longer than eight weeks) can be caused by many etiologies, four conditions account for most cases: upper airway cough syndrome, gastroesophageal reflux disease/laryngopharyngeal reflux disease, asthma, and nonasthmatic eosinophilic bronchitis. Patients should be evaluated clinically (with spirometry, if indicated), and empiric treatment should be initiated. Other potential causes include angiotensin-converting enzyme inhibitor use, environmental triggers, tobacco use, chronic obstructive pulmonary disease, and obstructive sleep apnea...
November 1, 2017: American Family Physician
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