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Persistent cough: is it asthma?

A O Faniran1, J K Peat, A J Woolcock

  • 1Department of Medicine, University of NSW, St George's Hospital, Kogarah, Australia. s.faniran@unsw.edu.au

Archives of Disease in Childhood
|April 8, 1999
PubMed
Summary

This study found that children with persistent cough showed less illness and fewer allergies than those with wheeze. Many children with persistent cough were misdiagnosed with asthma, highlighting a need for better diagnosis and treatment.

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Area of Science:

  • Pediatric Pulmonology
  • Allergy and Immunology
  • Epidemiology

Background:

  • Persistent cough is a common symptom in children.
  • The diagnosis of asthma in children presenting with cough is often challenging.
  • Cough variant asthma is a debated clinical entity.

Purpose of the Study:

  • To investigate the characteristics of children with persistent cough in a community setting.
  • To determine if persistent cough in children aligns with asthma diagnosis criteria.
  • To evaluate the prevalence of atopy and morbidity in children with persistent cough versus wheeze.

Main Methods:

  • A validated questionnaire was administered to parents of 1245 randomly selected children aged 6-12 years.
  • Skin prick tests were used to measure atopy.
  • Comparison of morbidity and atopy between children with persistent cough and children with wheeze.

Main Results:

  • Children with persistent cough exhibited lower morbidity and less atopy compared to children with wheeze.
  • The study did not confirm the existence of "cough variant asthma" as a distinct syndrome.
  • A significant proportion of children with persistent cough had a prior asthma diagnosis and received asthma medications, including inhaled corticosteroids.

Conclusions:

  • The findings suggest that persistent cough in children may not represent "cough variant asthma" and is associated with less severe allergic disease.
  • There is a need for further research to establish appropriate diagnostic criteria and treatment strategies for persistent cough in pediatric populations.
  • Current management of persistent cough may involve overdiagnosis and overtreatment for asthma.

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