Journal of the Korean Pediatric Society 1995;38(10):1340-1348.
Published online October 15, 1995.
Cough Variant Asthma
Bin Cho, Joon Sung Lee
Department of Pediatrics, Catholic University Medical College, Seoul, Korea
기침이형천식
조빈, 이준성
카톨릭대학교 의과대학 소아과학교실
Abstract
Purpose
: Asthma, one of the most common of chronic cough in children, is easily diagnosed when classic triad; cough, wheezing, dyspnea are presented. However, it has become apparant that cough may be the sole manifestation of this disease. This cough variant asthma is underdiagnosed and undertreated. The clinical manifestations and subject variables of asthma especially, cough variant asthma had been evaluated for the early diagnosis and treatment.
Methods
: This study had been performed at Pediatric Allergy Clinic of Kangnam St. Mary's Hospital from January 1, 1993 to December 31,1993. The types and patterns of cough, presence of cough variant asthma, history of allergic disease, triggering factors of cough, birth-months and presence of sinusitis were evaluated in 81 children with chronic cough diagnosed as bronchial asthma by bronchodilator and/or metacholine challenge test.
Results
: 1) Fifty seven patients(70.4%) were typical cough variant asthma. 2) Male are more predominant than female(M:F=2.7:1). 3) The diagnosis of asthma tends to be delayed after the age of 5(67 cases; 82.7%). 4) Dry cough was noted in 44 cases(54.3%) and wet type in 37 cases(46.9%). Most patients coughed especially at mid-night(38 cases 46.9%) or early morning(32 cases; 39.5%) 5) Fifty seven cases(70.3%) were combined with at least one presenting allergic diasease and 59 cases(72.8%) with positive family history. 6) Seventy four cases(91.4%) had at least one triggering factor of cough. 7) Seventy cases(21.0%) were combined with paranasal sinusitis. 8) Asthmatic children with chronic cough tends to be born on August, September, October and January(p=0.018) 9) Blood type O(38.3%) is more predominant and type B(16.0%) is less predominant in cough variant asthma than in normal population, but statistically not significant(p=0.120).
Conclusion
: In the diagnostic approach of chronic cough, careful history taking of cough patterns, triggering factors of cough, presence of allergic diasease and family history of allergy should be necessary and evaluation of combining sinusitis must be done. As the most common cause of chronic cough in children, the cough variant asthma should be considered first if mid-night or early morning cough, triggering factors of cough or positive allergic histories are presented. Although cough is the sole manifestations of chronic cough, trial of bronchodilators and/or bronchial challenge test should be taken.
Key Words: Cough variant asthma, Chronic cough, Bronchial asthma


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