Clinical significance of cough and wheeze in the diagnosis of asthma.

Kelly, Yvonne; Brabin, Bernard; Milligan, Paul; Reid, James; Heaf, D P; Pearson, M

doi:10.1136/adc.75.6.489

Cited by 88 publications

(61 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Night cough appeared unrelated to lung function and hyperresponsiveness in wheezing school age children [83]. Compared to cough with recurrent wheeze, cough without wheeze had a favourable prognosis in preschool children, and tended to resolve before the age of 6 yrs in most cases [29]. The possible interactions between asthma and cough in children have been comprehensively reviewed by CHANG [84].…”

Section: Asthmamentioning

confidence: 99%

“…How often do normal children cough? Questionnaire data suggest that f10% of preschool and early schoolaged children have persistent, chronic cough unrelated to colds, and without wheeze [27][28][29]. Cough without wheeze was associated with environmental factors, including dampness in the home and air pollution, and is strongly related to socioeconomic status.…”

Section: Chronic Cough In Childhoodmentioning

confidence: 99%

See 1 more Smart Citation

The diagnosis and management of chronic cough

Morice¹

2004

Eur Respir J

468

360

View full text Add to dashboard Cite

Section: Asthmamentioning

confidence: 99%

Section: Chronic Cough In Childhoodmentioning

confidence: 99%

The diagnosis and management of chronic cough

Morice¹

2004

Eur Respir J

468

360

View full text Add to dashboard Cite

“…31,32 There is also no doubt that isolated cough may frequently be overdiagnosed as asthma. 33 Chronic non-specific cough frequently improves with time and without treatment. 34,35 However, in a specialist clinic, where a highly selected group of children are seen, children who cough in response to typical asthma triggers, and improve when treated with asthma medications are not uncommonly seen.…”

Section: Does Cough Variant Asthma Exist?mentioning

confidence: 99%

Diagnosis of asthma in children under five

Bush

2007

Primary Care Respiratory Journal

View full text Add to dashboard Cite

Summary: Cough and wheeze are common symptoms in childhood, but mostly do not signify a serious illness. On the basis of history and examination, such children should be allocated into one of five diagnostic categories. Very few need additional tests, although there are specific pointers in the initial evaluation which should actively be sought, and result in referral for investigation. In a community setting, isolated cough with no wheeze or breathlessness is most unlikely to be due to asthma. In pre-school children who cannot perform lung function tests, a therapeutic trial of asthma treatment may be indicated, but a three step protocol is mandatory, stopping therapy if there appears to be a response, and only restarting if symptoms recur. In older children, documentation of variable airflow obstruction before giving a diagnosis of asthma is important, to avoid overdiagnosis. Prophylactic therapy on a long term basis with inhaled steroids in preschool children does not reduce the likelihood of progression to asthma in midchildhood, and the results of treatment in terms of symptoms are disappointing.

show abstract

“…Where cough is the sole complaint, the British Thoracic Society's recent guidelines state "criteria for defining asthma in the presence of chronic or recurrent cough have not been adequately defined" [8]. Clinical and epidemiological aspects of persistent cough differ from those of asthma [9,10] and only the minority of night-time coughers turn out to have asthma [11]. "Cough-variant asthma" may be an asthma phenotype [12] and it seems important to identify those persistent coughers who might benefit from asthma treatment.…”

mentioning

confidence: 99%

Airway resistance and atopy in preschool children with wheeze and cough

McKenzie¹,

Bridge²,

Healy³

2000

Eur Respir J

View full text Add to dashboard Cite

Airway resistance and atopy in preschool children with wheeze and cough. S.A. McKenzie, P.D. Bridge, M.J.R. Healy. #ERS Journals Ltd 2000. ABSTRACT: The extent to which the measurement of airways resistance by the interrupter technique (Rint) distinguishes preschool children with previous wheeze from those with no respiratory symptoms and helps to classify subjects with persistent cough, was investigated.Rint was measured before and after salbutamol treatment in 82 children with recurrent wheeze, 58 with isolated cough and 48 with no symptoms (control subjects). Their mean age (range) was 3.7 yrs (2±<5 yrs).Median baseline Rint was higher (p<0.0001) in wheezers than in either coughers or control subjects (1.16, 0.94 and 0.88 kPa . L -1 . s -1 respectively); coughers did not differ significantly from control subjects (p=0.14). The median ratios of baseline to postsalbutamol measurements (bronchodilator response (BDR)) in the groups differed significantly (1.40, 1.27 and 1.07, p#0.01 for all), suggesting that coughers occupy an intermediate position. A BDR ratio of >1.22 had a specificity and sensitivity for wheeze of 80% and 76% respectively. Twenty-eight coughers had a BDR ratio >1.22. Wheezers' immunoglobulin E was inversely related to baseline Rint.It is concluded that measurements of airway resistance by the interrupter technique are useful for classifying preschool children with respiratory symptoms and could be used to monitor the effect of interventions. The relation between atopy and airways resistance suggests that they have separate roles in preschool wheezing. Coughers with a high bronchodilator response could represent "cough-variant" asthma in children who have baseline airway resistance by the interrupter technique measurements similar to control subjects. Whether these children develop classical asthma will only be known at follow-up later in childhood. Eur Respir J 2000; 15: 833±838.

show abstract

Clinical significance of cough and wheeze in the diagnosis of asthma.

Abstract: Objectives-(l) To determine the prevalence of cough, wheeze, and breathlessness, both as single symptoms and in combination, in primary schoolchildren and their relation to doctor diagnosed asthma. (2)

Cited by 88 publications

References 28 publications

The diagnosis and management of chronic cough

The diagnosis and management of chronic cough

Diagnosis of asthma in children under five

Airway resistance and atopy in preschool children with wheeze and cough

Contact Info

Product

Resources

About