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Persistent cough in an adolescent.

M T Stein1, G Harper, J Chen

  • 1University of California, San Diego, USA.

Journal of Developmental and Behavioral Pediatrics : JDBP
|December 23, 1999
PubMed
Summary
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A 14-year-old girl with asthma experienced a persistent cough unresponsive to asthma medications. Psychological factors, specifically family tension, were suspected as the cause of the conversion reaction.

Area of Science:

  • Pediatrics
  • Psychosomatic Medicine

Background:

  • A 14-year-old female with a history of mild asthma presented with a 3-month history of nonproductive cough.
  • The cough worsened with exercise and was unresponsive to albuterol and cromolyn inhalers.

Observation:

  • The patient denied fever, rhinorrhea, or chest pain. Physical examination and chest radiograph were normal.
  • Despite treatment with inhaled steroids, montelukast, and normal peak flow readings, the cough persisted.
  • The patient reported experiencing tension at her father's home due to arguing adults.

Findings:

  • The persistent cough, unresponsive to standard asthma treatments and diagnostic tests, suggested a non-physical etiology.
  • The pediatrician suspected a conversion reaction, a psychosomatic condition, as the cause of the persistent cough.

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Implications:

  • This case highlights the importance of considering psychological factors in pediatric patients with persistent, unexplained symptoms.
  • Recognizing conversion reactions is crucial for appropriate diagnosis and management, potentially avoiding unnecessary medical interventions.