A Pathogenic Triad in Chronic Cough

Palombini, Bruno Carlos; Villanova, Carlos A; Araújo, Elisabeth; Gastal, Otávio Leite; Alt, Dayse; Stolz, Daiana Prestes; Palombini, Carlos

doi:10.1378/chest.116.2.279

Cited by 282 publications

(52 citation statements)

References 19 publications

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“…Earlier studies indicated that pathological reflux parameters (the DeMeester score and the fraction time below pH 4 during 24 h) could be expected in 41–78% of patients with GERD-related pulmonary diseases [6, 7]. Our results confirm this: the DeMeester score was abnormal in 57% of our patients, with a predominance of nocturnal acid reflux (52%).…”

Section: Discussionsupporting

confidence: 88%

“…This may be related in part to the diversity of the methods applied in the diagnosis of GERD. In studies based on 24-hour esophageal pH monitoring, Palombini et al [6] detected a pathological GER in 41%, while Gastal et al [4] did so in 50% of patients with chronic cough. In asthmatic patients, Schnatz et al [7] and Sontag et al [8] reported a higher prevalence of GERD (78–80%), while Gastal et al [4] observed a lower prevalence (44%).…”

Section: Discussionmentioning

confidence: 99%

“…These investigations have shown that GERD is responsible for the generation or maintenance of chronic cough in 10–40% of the patients [4,5,6,7], while the prevalence of GERD among asthma patients has been reported to be 30–89% [4, 5, 8]. There have been only a few studies on the prevalence of respiratory complications in a non-selected population of GERD patients.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of Respiratory Symptoms and Diseases Associated with Gastroesophageal Reflux Disease

et al. 2005

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Aim: Investigation of the prevalence of respiratory symptoms and diseases associated with gastroesophageal reflux disease (GERD). Patients and Methods: 299 subjects with GERD were submitted to upper gastrointestinal endoscopy and 24-hour esophageal pH monitoring and a symptom analysis. Results: Chronic respiratory symptoms or diseases were present in 18% (56/299). Chronic cough was observed in 42/56 patients, while typical reflux symptoms such as heartburn and acid regurgitation were observed in 30/56 and 24/56 cases, respectively. The prevalence of airway diseases was chronic bronchitis 12/56, asthma 10/56, recurrent pneumonia 10/56, chronic sinusitis 7/56 and chronic laryngitis 1/56. In patients with respiratory complications pathologic acid reflux was established in 29/51 cases on the basis of the DeMeester score, while 17/51 had pathologic postprandial, nocturnal or diurnal reflux events. Upper gastrointestinal endoscopy revealed a normal esophageal mucosa in 6/56, Savary-Miller stage I esophagitis in 23/56, stage II in 15/56, stage III in 5/56 and stage IV in 6/56 patients. Conclusions: These investigations have demonstrated an abnormal 24-hour pH score in about half of the patients with GERD-associated respiratory complications, and indicated that short reflux events are characteristic of the reflux activity in one third of this population.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prevalence of Respiratory Symptoms and Diseases Associated with Gastroesophageal Reflux Disease

et al. 2005

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“…The three causes are so frequent that Palombini et al [15] even called them as a pathogenic triad of chronic cough. Recently, eosinophilic bronchitis has also been recognized as one important cause of chronic cough [4].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Cause Distribution between Elderly and Non-Elderly Patients with Chronic Cough

Wei

Lü

et al. 2008

Respiration

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Background: The causes of chronic cough in elderly patients have not been specifically investigated. Therefore, it remains to be determined whether chronic cough differs between elderly and non-elderly patients. Objectives: To investigate the distribution of causes of chronic cough in elderly patients in comparison with etiologies of chronic cough observed in non-elderly patients. Methods: From 2,989 new patients presenting consecutively to the Department of Respiratory Medicine of the Tongji Hospital over a 1.5-year period, 287 patients with chronic cough were enrolled in the study. Patients aged ≥60 years were assigned to the elderly group. The elderly group comprised 104 patients and the non-elderly group the remaining 183 patients. The causes of cough were primarily evaluated according to a modification of Irwin’s anatomic diagnostic protocol which included induced sputum cytology, verified by the specific therapy. Results: Cough-variant asthma (34.6 vs. 41.5%) and upper airway cough syndrome (19.3 vs. 23.5%) were the most common causes of chronic cough both in the elderly and non-elderly groups. The distribution of causes and frequency were significantly different between elderly and non-elderly groups: angiotensin-converting enzyme inhibitor (ACEI)-induced cough (16.3 vs. 1.7%, χ² value = 22.12, p < 0.001) and gastroesophageal reflux disease (GERD; 10.6 vs. 3.7%, χ² value = 5.14, p = 0.02) were more common in the elderly group. Conclusions: A more frequent incidence of ACEI-induced cough and GERD is the distinctive feature in the cause distribution between elderly and non-elderly patients with chronic cough.

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“…In this form, the coronal diameter of the trachea decreases, while the sagittal diameter increases, and the characteristic shape of the saber-sheath appears (4)(5)(6)(7)(8). The incidence of excessive dynamic airway collapse was reported to be 14% in patients who underwent FOB due to chronic cough, 5% in patients having any respiratory complaints, 13% in patients with a known pulmonary disease, and 44% in patients with chronic bronchitis (9)(10)(11)(12). In the studies conducted, a rate of 57% was reported for the coexistence of COPD and EDAC (13).…”

Section: Introductionmentioning

confidence: 99%

Investigation of Relationship between Comorbid Factors and Excessive Dynamic Airway Collapse and Frequency of Hospitalization in Frequently Hospitalized COPD Patients

Yarkin¹,

Ağca²,

Acar³

et al. 2015

Eurasian J Pulmonol

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Objective: "Frequent hospitalization" is defined as at least 2 hospitalizations per year in chronic obstructive pulmonary disease (COPD). However, we witness hospitalizations at 2-3-month intervals in some patients in our clinical practice. In our study, the factors considered to be associated with frequent hospitalizations were investigated in a selected patient group.Methods: Thirty-four COPD patients being hospitalized at least twice per year were included in the study. The patients' demographic features, laboratory findings, physical activity scores, comorbidities, and respiratory functions were recorded. They underwent transthoracic echocardiography and fiberoptic bronchoscopy (FOB). The patients were categorized as Group 1 (patients hospitalized twice per year) and Group 2 (patients hospitalized more than twice per year). These groups were compared with regard to parameters considered to increase the frequency of hospitalization.Results: Twenty-eight (82%) of the patients were male. The mean age was 65±8 (46-82) years, and the mean hospitalization number was 3.3±1.3 (2-6). There were 12 patients in Group 1 and 22 patients in Group 2. The rates of being in advanced age, showing lower physical activity, being in advanced stage, having disease for more than 10 years, and using a nebulizer and oxygen at home were found to be significantly higher in Group 2 than in Group 1. FEV 1 (expected %) level was 47.9% in Group 2, while it was 56% in Group 1 (p=0.003). The number of comorbidities was approximately 1.5 in Group 1 and 2.7 in Group 2 (p=0.014). Pulmonary hypertension (n=11) and heart failure (n=10) were identified only in Group 2 (p=0.003, p=0.006). Excessive dynamic airway collapse (EDAC) was detected in 17 (50%) patients through FOB, and 16 of them were in Group 2. Logistic regression analysis revealed the existence of EDAC and a low level of FEV 1 (expected %) as the independent factors that affected the number of hospitalizations. Conclusion:It was suggested that the existence of EDAC and decreased FEV 1 can increase the frequency of hospitalization in COPD patients who are hospitalized frequently.

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A Pathogenic Triad in Chronic Cough

Cited by 282 publications

References 19 publications

Prevalence of Respiratory Symptoms and Diseases Associated with Gastroesophageal Reflux Disease

Prevalence of Respiratory Symptoms and Diseases Associated with Gastroesophageal Reflux Disease

Comparison of Cause Distribution between Elderly and Non-Elderly Patients with Chronic Cough

Investigation of Relationship between Comorbid Factors and Excessive Dynamic Airway Collapse and Frequency of Hospitalization in Frequently Hospitalized COPD Patients

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