Persistent cough: an unusual cause

Barker, Bethan; Moudgil, Harmesh; Slocombe, G. W.; Srinivasan, Koottalai

doi:10.1136/thx.2010.135251

Cited by 5 publications

(2 citation statements)

References 34 publications

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“…Spirometry was not significantly altered in any of the patients with F/P+ CEL and cough reported so far (table 1), and although chest CT scans indicate bronchial rather than interstitial disease [7,8], the functional and imaging studies do not support eosinophilic bronchiolitis [14]. Ours is the only report exploring airway hyperreactivity with a histamine provocation test that was markedly perturbed.…”

Section: Discussionmentioning

confidence: 86%

“…Furthermore, chronic cough as the first and most prominent manifestation of F/P+ CEL has been previously reported in 4 patients (table 1) [7,8,9,10]. Thus, despite findings arguing against F/P+ CEL in our patient (absence of organomegaly or elevated serum vitamin B 12 or tryptase; normal blood count besides HE; negative FISH and single-step RT-PCR for the F/P rearrangement), we persevered and eventually detected the F/P rearrangement by nested RT-PCR.…”

Section: Discussionmentioning

confidence: 95%

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Severe Prolonged Cough as Presenting Manifestation of FIP1L1-PDGFRA+ Chronic Eosinophilic Leukaemia: A Widely Ignored Association

Roufosse

Heimann²,

Lambert

et al. 2016

Respiration

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Chronic eosinophilic leukaemia associated with the FIP1L1-PDGFRA fusion gene (F/P+ CEL) is a rare cause of marked persistent hypereosinophilia, arising almost exclusively in male patients. Clinical presentations are heterogeneous with a higher incidence of eosinophil-mediated cardiomyopathy than in other hypereosinophilic syndrome variants. Features of chronic myeloproliferative disease are often present, including splenomegaly and elevated serum vitamin B₁₂ levels. The diagnosis is made by fluorescence in situ hybridization (FISH) showing the deletion of the CHIC2 locus and/or RT-PCR showing the FIP1L1-PDGFRA fusion transcript. Treatment with imatinib mesylate, a tyrosine kinase inhibitor, results in rapid and complete resolution of hypereosinophilia and associated symptoms, except for those related to sub-endocardial fibrosis that may be irreversible. We report the case of a male patient in whom isolated intractable cough remained the only clinical manifestation of F/P+ CEL for 4 years. Furthermore, eosinophil autofluorescence, an as yet unreported artefact in this setting, precluded the detection of the CHIC2 deletion and further delayed diagnosis, underlining that both FISH and RT-PCR should be performed when this disease is suspected.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 95%

Severe Prolonged Cough as Presenting Manifestation of FIP1L1-PDGFRA+ Chronic Eosinophilic Leukaemia: A Widely Ignored Association

Roufosse

Heimann²,

Lambert

et al. 2016

Respiration

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Cough in Asthma Is due to Eosinophilic Airway Inflammation: A Pro/Con Debate

Brightling

Dicpinigaitis

2013

Lung

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Multiple prospective studies have demonstrated that asthma is among the most common etiologies of chronic cough, along with upper-airway cough syndrome (formerly known as postnasal drip syndrome) and gastroesophageal reflux disease. More recently, the entity of nonasthmatic eosinophilic bronchitis has been appreciated as a significant cause of chronic cough worldwide. Chronic cough associated with both of these conditions typically responds well to therapy with systemic or inhaled corticosteroids, thus leading to a general assumption that the suppression of eosinophilic airway inflammation explains the improvement in cough. However, some recent studies challenge a causal relationship between eosinophilic airway inflammation and cough in asthmatics. The 4th American Cough Conference, held in New York in June 2013, provided an ideal forum for discussion and debate of this issue between two internationally recognized experts in the field of asthma and chronic cough.

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