Children with chronic nonspecific isolated cough

Area of Science:

• Pediatric Pulmonology
• Allergy and Immunology

Background:

• Chronic nonspecific isolated cough (NIC) is common in children.
• Distinguishing between spontaneous resolution and the development of asthma is crucial.
• Understanding treatment responses in children who develop asthma is important.

Purpose of the Study:

• To identify clinical differences between children with NIC who spontaneously recover versus those who develop asthma.
• To explore differences in response to inhaled corticosteroids (ICS) among children who develop asthma.

Main Methods:

• Children with chronic NIC were managed with either a wait-and-review approach or a 2-week trial of inhaled budesonide.
• Responses were assessed using a validated cough score, with treatment extended to 8 weeks for partial responders.
• All children were followed up for a mean of 21 months.

Main Results:

• 71% of children experienced spontaneous cough resolution; 28% relapsed and responded to ICS, indicating asthma development.
• Aeroallergen sensitization and a history of chronic cough significantly increased asthma risk.
• Cough duration, cough score, family history of asthma, and serum eosinophilia did not predict the final diagnosis.

Conclusions:

• The majority of chronic NIC cases do not recur.
• Initial ICS response can be misleading; however, ICS trials are beneficial for children with atopic sensitization or a history of chronic cough.
• No significant differences were observed in treatment response duration between 2-week and 8-week ICS trials in children who developed asthma.