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What is chronic cough in children?
Iulia Ioan1, Mathias Poussel2, Laurianne Coutier3
1Service D'explorations Fonctionnelles Pédiatriques, Hôpital D'enfants Centre Hospitalier Universitaire de Nancy, Vandoeuvre les Nancy, France.
Insights
Pediatric cough reflex matures from birth, with acute cough common in early childhood. Development, including puberty, influences cough sensitivity, leading to sex differences in adults and necessitating age-specific management.
Area of Science:
- Pediatric Pulmonology
- Developmental Physiology
Background:
- The cough reflex undergoes significant modulation during human growth and development.
- Acute cough is a prevalent respiratory symptom in early childhood, increasing with maturation.
- Pubertal development influences cough thresholds, contributing to sex-specific differences in adulthood.
Purpose of the Study:
- To elucidate the developmental trajectory of the cough reflex in children.
- To highlight the unique characteristics of pediatric cough compared to adult cough.
- To emphasize the need for developmentally tailored approaches in diagnosing and managing pediatric cough.
Main Methods:
- Review of existing literature on pediatric cough reflex development and common etiologies.
- Analysis of how maturation and puberty impact cough sensitivity.
- Correlation of specific cough characteristics with underlying pediatric respiratory conditions.
Main Results:
- The cough reflex is absent at birth, developing with maturation and influenced by puberty.
- Asthma, protracted bacterial bronchitis, and viral infections are key causes of chronic cough in children.
- Cough characteristics (e.g., barking, whooping, productive) can indicate specific conditions like croup, pertussis, or bronchiectasis.
Conclusions:
- Pediatric cough exhibits distinct features from adult cough due to developmental variations.
- Understanding these developmental particularities is crucial for accurate diagnosis and effective, age-specific management strategies.
Abstract:
The cough reflex is modulated throughout growth and development. Cough-but not expiration reflex-appears to be absent at birth, but increases with maturation. Thus, acute cough is the most frequent respiratory symptom during the first few years of life. Later on, the pubertal development seems to play a significant role in changing of the cough threshold during childhood and adolescence resulting in sex-related differences in cough reflex sensitivity in adulthood. Asthma is the major cause of chronic cough in children. Prolonged acute cough is usually related to the long-lasting effects of a previous viral airway infection or to the particular entity called protracted bacterial bronchitis. Cough pointers and type may orient toward specific etiologies, such as barking cough in croup or tracheomalacia, paroxystic whooping cough in Pertussis. Cough is productive in protracted bacterial bronchitis, sinusitis or bronchiectasis. Cough is usually associated with wheeze or dyspnea on exertion in asthma; however, it may be the sole symptom in cough variant asthma. Thus, pediatric cough has particularities differentiating it from adult cough, so the approach and management should be developmentally specific.
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