Cough variant asthma with coexisting gastroesophageal reflux disease: A case report

Chronic cough is a common clinical challenge and a leading cause of outpatient visits to respiratory clinics. In primary care settings, limited diagnostic resources and the absence of standardized evaluation protocols often result in misdiagnosis and suboptimal management. The present report presents the case of a 30-year-old woman with a >1-year history of persistent, non-productive cough unresponsive to initial anti-inflammatory and antitussive therapies. Comprehensive evaluations revealed coexisting cough-variant asthma and gastroesophageal reflux disease, supported by a positive bronchial provocation test, elevated fractional exhaled nitric oxide and laryngoscopic evidence of reflux laryngitis. Early treatment with a combination of inhaled corticosteroid, leukotriene receptor antagonist, acid suppressant and prokinetic agents produced only a limited response. However, a pathophysiology-guided dual therapy approach ultimately resulted in the full resolution of symptoms, as reported by the patient during structured telehealth follow-up over 6 months. The present case underscores the multifactorial nature of chronic cough and highlights the value of systematic evaluation, personalized treatment strategies and multidisciplinary collaboration. It also emphasizes the importance of improving diagnostic capacities in primary care to prevent the mismanagement of chronic cough.