Atopic cough: little evidence to support a new clinical entity

McGarvey, Lorcan; Morice, Alyn H.

doi:10.1136/thorax.58.8.736-a

Cited by 29 publications

(26 citation statements)

References 17 publications

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“…It is uncertain if higher capsaicin sensitivity indicates the presence of 'atopic cough'37 in our study participants or rather represents an overall phenomenon of enhanced cough sensitivity for older females. Current literature is unclear on the presence of 'atopic cough' 37…”

Section: Discussionmentioning

confidence: 89%

Capsaicin cough sensitivity is related to the older female predominant feature in chronic cough patients

Song

Kim

et al. 2014

Allergy Asthma Immunol Res

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PurposeThe present study aimed to examine the age and gender distributions among chronic cough patients referred to a tertiary cough clinic in Korea, and to investigate clinical factors related to the demographic findings.MethodsStudy participants were unselectively recruited from adult chronic cough patients who attended the cough clinic for the first time during one year. To validate their representativeness, their age and gender distributions were compared to the entire chronic cough population, or with those presenting with other chronic disease. Data from the baseline investigations were analyzed to identify clinical factors related to the demographic findings.ResultsA total of 272 chronic cough patients were included. They had a middle-aged female predominant feature (mean age: 52.8±15.7 years and female 69.1%). Their age and gender distributions were almost identical to the entire chronic cough population, but were distinct from patients with hypertension. Among clinical factors, the older female predominance was associated with enhanced capsaicin cough sensitivity, and also with the presence of 'cough by cold air' symptom. Allotussia and laryngeal paresthesia were highly common in chronic cough patients, affecting 94.8% and 86.8% of them, respectively.ConclusionsThe present study demonstrated older female predominance among adult chronic cough patients attending a referral cough clinic in Korea. The demographic features were significantly associated with the capsaicin cough responses and also potentially with allotussia (particularly cold air as the trigger). These findings suggest a role of cough reflex sensitization in the pathophysiology of chronic cough in adults.

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Section: Discussionmentioning

confidence: 89%

Capsaicin cough sensitivity is related to the older female predominant feature in chronic cough patients

Song

Kim

et al. 2014

Allergy Asthma Immunol Res

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“…Sel ten sieht man als Ur sa che für den chro ni schen Hus ten eine eo si no phi le Bron chi tis. Sie ist ge kennzeich net durch Eo si no phi lie in der Bronchus bi op sie oder im Spu tum (Eo si no phile >3), Feh len von Atem wegs ob struk tion und bron chia ler Hyper rea gi bi li tät, aber Nach weis ei ner er nied rig ter Hus ten schwelle; auf Kor ti kos te roi de spricht der Hus ten ("ato pic cough") ex zel lent an [11,20].…”

Section: Introductionunclassified

Husten

Konietzko

2005

Pneumologe

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On li ne pub li ziert: 25. März 2005 © Sprin ger Me di zin Ver lag 2005Hus ten ist eine kom ple xe, zen tral nervös ge steu er te, ex plo siv ab lau fen de Form der Aus at mung. Auf ga be des Hus ten me cha nis mus ist die Ent fernung von Fremd kör pern und Schleim aus Ra chen, Kehl kopf, Tra chea und Bron chi en. Hus ten kann re flek to risch aus ge löst, aber auch will kür lich einge setzt wer den. Als Schutz re flex ist Hus ten für das Über le ben des Menschen not wen dig. Ver sagt er, kann es akut, z. B. bei Fremd kör pe ra spi ra ti on, zum Er sti cken und dau er haft, z. B. bei Atem mus kel schwä che, zu Schleim reten ti on und re spi ra to ri scher In suf fi zienz kom men. Kom plex "Hus ten"Die ver glei chen de Tier phy sio lo gie hat uns ge lehrt, dass Über le ben auch ohne Hus ten mög lich ist: Rat ten z. B. kön nen nicht husten, trotz dem er sti cken sie nicht an ih rem Schleim -dank ei nes aus ge klü gel ten muko zi lia ren Klär sys tems. Und ha ben Sie schon ein mal Vö gel hus ten hö ren?An de rer seits gibt es Men schen, die ein gan zes Le ben lang hus ten, ohne krank zu sein. Von die ser "crux me di corum" wird noch die Rede sein. Die meis ten Hus ter al ler dings lei den an ih rem Hus ten, sie wa gen sich kaum noch in die Öf fent lichkeit, las sen sich so zi al mehr und mehr isolie ren und lan den schließ lich, nach dem sie von Arzt zu Arzt ge lau fen sind, ohne Lin de rung ih rer Be schwer den er fahren zu ha ben, beim Psych ia ter. Auch der ist in der Re gel über for dert und schickt den Pa ti en ten zu rück. Ein sol cher "Staffel lauf " muss aber nicht schick sal haft sein: In spe zia li sier ten Am bu lan zen, die sich des Kom ple xes "Hus ten" an neh men, wer den Hei lungs ra ten von 90 er zielt [6]. Der we sent li che Grund für ih ren Erfolg ist der mul ti dis zi pli näre An satz bei der Ab klä rung des Pro blems und der Behand lung des Pa ti en ten. Dies gilt ins beson de re für den pro ble ma ti schen chro nischen Hus ten, der de fi niert ist als Hus ten von mehr als 8 Wo chen Dau er [15]. Auf den aku ten Hus ten, der di ag nos tisch weni ger an spruchs voll ist und de fi ni ti onsge mäß nach 2-8 Wo chen ver schwin det, wird nur hier nur kurz ein ge gan gen. Zu den spe zi el len Be lan gen des Hus tens im Kin desal ter, ei nes der häu figs ten Krankheits bil dern in der Pä di at rie, sei auf die kürz lich er schie ne nen Leit li ni en der "Euro pean Re spi ra to ry So cie ty" [23] und der "Deut schen Ge sell schaft für Pneu mo logie" [17] ver wie sen. Bei de sind vor züg-lich ge lun gen und bil den die Ba sis für den vor lie gen den Bei trag. Epi de mio lo gieAku ter Hus ten ist der häu figs te Grund zur Kon sul ta ti on ei nes Arz tes. Aber auch der chro ni sche Hus ten ist ein häu fi ger Grund, den Spe zia lis ten auf zu su chen: 10-40 al ler Über wei sun gen zum Pneu molo gen er fol gen we gen ei nes chro ni schen Hus tens. Welt weit lei den bis zu 40 der Be völ ke rung un ter Dau er hus ten, bei den Er wach se nen sind es 30 mit nächt lichem Hus ten, 10 mit pro duk ti vem und 10 m...

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“…However, there remains discussion amongst the experts whether atopic cough is a separate condition that causes chronic cough [Fujimura and Ogawa, 2003;Mcgarvey and Morice, 2003]. Some, in fact, suggested that patients with atopic cough are most likely atopic individuals with cough-variant asthma [Mcgarvey and Morice, 2003]. However, Fujimura and colleagues have defined atopic cough with its specific pathophysiology and lack of progress to classic asthma [Fujimura and Ogawa, 2003].…”

Section: Nonasthmatic Eosinophilic Bronchitismentioning

confidence: 99%

“…This condition is characterized by an increased cough response to inhaled capsaicin, presence of eosinophils in the sputum and the submucosal biopsies of trachea and bronchi but not in the bronchoalveolar lavage (BAL) [Fujimura et al 2005[Fujimura et al , 2003[Fujimura et al , 2000[Fujimura et al , 1997[Fujimura et al , 1992. However, there remains discussion amongst the experts whether atopic cough is a separate condition that causes chronic cough [Fujimura and Ogawa, 2003;Mcgarvey and Morice, 2003]. Some, in fact, suggested that patients with atopic cough are most likely atopic individuals with cough-variant asthma [Mcgarvey and Morice, 2003].…”

Section: Nonasthmatic Eosinophilic Bronchitismentioning

confidence: 99%

“…Although these conditions may differ phenotypically, eosinophilic airway inflammation forms their common denominator. Whether these conditions embody the 'asthma syndrome' or whether they represent independent entities per se remains a matter of discussion [Mcgarvey et al 2003]. In fact, there is a body of evidence to suggest that some patients with those conditions if not diagnosed or treated appropriately may in fact progress to develop full characteristics of classic asthma [Irwin et al 2006;Fujimura et al 2005aFujimura et al , 2005bFujimura et al , 2005cFujimura et al , 2003Brightling et al 2003Brightling et al , 2000aBrightling et al , 2000bBrightling et al , 1999a Therapeutic Advances in Chronic Disease 2 (4) 1999b].…”

Section: Atypical Asthmamentioning

confidence: 99%

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Unusual asthma syndromes and their management

Morjaria

Kastelik

2011

Therapeutic Advances in Chronic Disease

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Asthma usually presents with symptoms of wheeze, dyspnoea and cough. However, clinicians should be aware of atypical presentation of this disorder when cough is the main or only symptom in conditions such as cough-variant asthma, nonasthmatic eosinophilic bronchitis and atopic cough. Early diagnosis and treatment of these conditions with inhaled corticosteroids improves symptoms in the majority of patients. Up to 10% of patients with asthma remain poorly controlled in spite of optimal standard therapy. These patients have been encompassed under the term 'treatment-refractory asthma' (TRA), have the greatest morbidity and are responsible for more than 50% of healthcare costs. In this review we discuss investigations, management and pathophysiology of the various phenotypes of atypical presentations of asthma as well as novel biological agents licensed and those that have been reported in clinical trials in terms of their efficacy and safety in TRA.

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Atopic cough: little evidence to support a new clinical entity

Cited by 29 publications

References 17 publications

Capsaicin cough sensitivity is related to the older female predominant feature in chronic cough patients

Capsaicin cough sensitivity is related to the older female predominant feature in chronic cough patients

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Unusual asthma syndromes and their management

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