Does idiopathic cough exist?

Area of Science:

• Pulmonology
• Allergy and Immunology
• Gastroenterology

Background:

• Chronic cough diagnosis is challenging, with up to 42% of specialist referrals having no clear cause.
• Potential missed diagnoses include asthma/eosinophilic airway syndromes and nonacid gastroesophageal reflux disease.
• A subset of patients presents with true idiopathic cough, lacking identifiable triggers.

Purpose of the Study:

• To review the current understanding of idiopathic cough.
• To identify potential diagnostic failures in chronic cough evaluation.
• To characterize the phenotype of patients with idiopathic cough.

Main Methods:

• Review of published evidence on chronic cough and idiopathic cough.
• Analysis of diagnostic challenges in specialist cough clinics.
• Phenotypic description of patients with unexplained chronic cough.

Main Results:

• Idiopathic cough affects a distinct group of patients, often middle-aged females.
• These patients typically present with prolonged, nonproductive cough.
• Cough reflex hypersensitivity is a noted characteristic in this cohort.

Conclusions:

• Failure to consider specific airway syndromes or reflux can lead to diagnostic delays.
• Idiopathic cough is associated with a specific patient phenotype.
• Further research is needed as no targeted therapies currently exist for idiopathic cough.