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Chronic cough in a hospital population; its relationship to atopy and defects in host defence
Insights
Chronic cough in children often indicates underlying atopy, similar to asthma, but with distinct immunological patterns. Further investigation is needed for simple cough in children.
Area of Science:
- Pediatric Pulmonology
- Immunology
- Allergy
Background:
- Chronic cough is a common pediatric complaint with varied etiologies.
- Asthma shares some risk factors with chronic cough, including eczema and allergen sensitivity.
- Understanding the immunological underpinnings of chronic cough is crucial for diagnosis and management.
Purpose of the Study:
- To investigate the background and aetiology of chronic cough in children.
- To compare children with simple cough, asthma, and healthy controls.
- To analyze immunological profiles associated with chronic cough and asthma.
Main Methods:
- Comparative study involving 180 children under 6 years: 60 with simple cough, 60 with asthma, and 60 controls.
- Assessment of clinical history, including eczema, chest deformity, and allergen reactivity.
- Immunological testing: IgE, IgM, IgG subclasses, eosinophilia, and lymphocytosis.
Main Results:
- Both cough and asthma were more frequent in boys and associated with atopic history.
- House dust mite sensitivity was prevalent in children with cough (57%) and asthma (75%).
- Asthma showed significant IgE elevation, eosinophilia, and lymphocytosis; cough group had low IgG3.
Conclusions:
- Children with simple cough form a heterogeneous group, many exhibiting atopy.
- Chronic cough in children shares some features with asthma but has distinct immunological markers.
- No major immune defects were identified in children with chronic cough.
Abstract:
The background and aetiology of chronic cough were investigated by comparing 60 children under 6 years with simple cough, 60 children with asthma, and 60 controls. Both cough and asthma were more common in boys and associated with a history of eczema, chest deformity, and skin reactivity to inhaled allergens, but these findings were more prevalent in asthma than cough. House dust mite sensitivity was found in 34 (57%) children with cough, 45 (75%) with asthma, and six (10%) controls. Tests of immunological function showed some high concentrations of IgM in groups with both cough and asthma, but high IgE concentrations, eosinophilia, and lymphocytosis were significant only in asthma. IgG1 and IgG2 concentrations were raised in some children with cough or asthma, but the only low subclass concentrations were of IgG3 observed in the group with cough. Children with simple cough represented a heterogeneous population but many showed evidence of atopy. Major defects of immunity were not observed.