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Chronic idiopathic cough: a discrete clinical entity?
Rubaiyat A Haque1, Omar S Usmani, Peter J Barnes
1Airways Disease Section, National Heart & Lung Institute, Imperial College, Dovehouse St, London, SW3 6LY, UK. r.haque@imperial.ac.uk
Chest
|May 13, 2005
Summary
Chronic idiopathic cough (CIC) patients often experience prolonged coughs triggered by upper respiratory infections (URIs) and exhibit heightened cough reflex sensitivity. These findings suggest CIC may be a distinct clinical condition.
Area of Science:
- Pulmonology
- Clinical Medicine
- Respiratory Medicine
Background:
- Specialist cough clinics diagnose many chronic cough cases.
- A subset of chronic coughers remains undiagnosed despite thorough investigation, termed chronic idiopathic cough (CIC).
Purpose of the Study:
- To compare clinical characteristics of CIC patients with diagnosed (non-CIC) chronic coughers.
- To identify a distinct clinical pattern differentiating CIC from non-CIC.
Main Methods:
- Retrospective analysis of medical records from 100 chronic cough patients.
- Study conducted at the Royal Brompton Hospital Cough Clinic, London (October 2000 - February 2004).
Main Results:
- CIC comprised 42% of patients; 71% of all patients were female, median age 57.
- CIC patients reported longer cough duration (72 vs 24 months), more URTI triggers (48% vs 24%), and lower capsaicin cough threshold.
- No significant differences in age or gender between CIC and non-CIC groups.
Conclusions:
- Chronic idiopathic cough is often initiated by URTI and persists for years.
- CIC patients demonstrate an exquisitely sensitive cough reflex.
- CIC may represent a distinct clinical entity with unidentified underlying pathology.