Cough in sarcoidosis patients

Kováčová, Eva; Buday, Tomáš; Vyšehradský, Róbert; Plevková, Jana

doi:10.1016/j.resp.2018.01.004

Cited by 6 publications

(5 citation statements)

References 96 publications

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“…Pulmonary sarcoidosis-associated cough is a common reason for patients to seek medical attention [ 15 ]. Using the Leicester Cough Questionnaire (LCQ), a patient-reported outcome quality-of-life measure of cough [ 16 ], sarcoidosis patients have been found to frequently experience a significant quality-of-life impairment related to cough [ 8 , 10 , 17 ].…”

Section: Coughmentioning

confidence: 99%

“…Sarcoid granulomas have a predilection for depositing in the airways [ 20 ] and the presence of endobronchial sarcoidosis lesions has been associated with cough [ 21 , 22 ]. This airway irritation/mechanical damage may cause an asthma-like syndrome [ 23 ] in which afferent nerve fibers are stimulated, thereby inducing cough [ 15 , 24 ]. Bronchial hyperreactivity with positive methacholine challenge testing is common in pulmonary sarcoidosis [ 25 , 26 , 27 ] and supports an asthma-like cough mechanism.…”

Section: Coughmentioning

confidence: 99%

“…Airway involvement in sarcoidosis is common, as random endobronchial biopsies have demonstrated granulomatous inflammation in nearly 60 percent of pulmonary sarcoidosis patients [ 20 ]. As mentioned, granulomas may also irritate airways causing bronchospasm by stimulating afferent nerve fibers [ 8 , 15 , 29 ] or asthma-like mechanisms [ 23 ]. As mentioned, the fact that some patients with acute exacerbations of pulmonary sarcoidosis improve after a few days of therapy [ 42 ] suggests that bronchospasm, airway nerve fibers, or asthma-like mechanisms are involved, as this seems too rapid a response to attribute to the resolution of granulomatous inflammation.…”

Section: Wheezingmentioning

confidence: 99%

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The Symptoms of Pulmonary Sarcoidosis

Judson

2023

JCM

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The aim of this manuscript is to provide a comprehensive review of the etiology, measurement, and treatment of common pulmonary symptoms associated with sarcoidosis. The assessment of symptoms associated with pulmonary sarcoidosis is an important component of disease management. Some symptoms of pulmonary sarcoidosis are sensitive but nonspecific markers of disease activity, and the absence of such symptoms provides evidence that the disease is quiescent. Although quantifiable objective measurements of pulmonary physiology and chest imaging are important in the assessment of pulmonary sarcoidosis, they correlate poorly with the patient’s quality of life. Because the symptoms of pulmonary sarcoidosis directly relate to how the patient feels, they are reasonable endpoints in terms of clinical research and individual patient care. Recently, the symptoms of pulmonary sarcoidosis are capable of being quantified via patient-reported outcome measures and electronic devices. We conclude that a thorough assessment of the symptoms associated with pulmonary sarcoidosis improves patient care because it is a useful screen for manifestations of the disease, provides insight into the pathophysiology of manifestations of sarcoidosis, and may assist in optimizing treatment.

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Section: Coughmentioning

confidence: 99%

Section: Coughmentioning

confidence: 99%

Section: Wheezingmentioning

confidence: 99%

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The Symptoms of Pulmonary Sarcoidosis

Judson

2023

JCM

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“…It is important, not only as a feature of significant disease (such as lung cancer or tuberculosis), but as a symptom due to its effect on the patient. Chronic cough (CC, defined as lasting greater than 8 weeks) of any cause is associated with both significant impairments in quality of life and potentially more severe underlying disease ( 6 - 9 ). Characteristics of cough, such as sputum production and diurnal variation, may vary between diseases, suggesting potentially different underlying mechanisms ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

Cough in chronic lung disease: a state of the art review

Hirons,

Rhatigan,

Kesavan

et al. 2023

J Thorac Dis

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Chronic cough (CC; ≥8 weeks in duration) is a common and burdensome feature of respiratory diseases. The understanding of cough has progressed significantly in recent years, albeit largely in refractory (unexplained) chronic cough (RCC) in the absence of other respiratory conditions. The prevalence of CC in respiratory diseases is poorly described, but estimates have been reported: asthma (8–58%), chronic obstructive pulmonary disease (COPD; 10–74%), bronchiectasis (82–98%), interstitial lung disease (ILD; 50–89%) and sarcoidosis (3–64%). CC in respiratory conditions generally predicts impaired health status and more severe disease. It is associated with increased symptom burden and disease severity in asthma, COPD, bronchiectasis and ILD, higher exacerbation frequency in asthma and bronchiectasis, and increased mortality and lung transplantation in idiopathic pulmonary fibrosis (IPF). Physiologically, heightened cough reflex sensitivity (CRS) has been reported and postulated to be mechanistic in isolated RCC. Cough reflex hypersensitivity (CRH) has also been reported in asthma, COPD, bronchiectasis, ILD and sarcoidosis. Unlike recent advances in isolated RCC, there are limited studies and understanding of central cough neuropathways in other respiratory conditions. Of note, dysfunctional central voluntary cough suppression neuropathways and physiology were observed in isolation in RCC; cough suppression is preserved in COPD. Understanding in the mechanism of RCC cannot be simply extrapolated to other respiratory conditions. The restricted understanding of cough mechanisms in these conditions has limited cough-specific therapeutic options in this context. There is currently an unmet need to expand our understanding of cough in chronic respiratory conditions, both in order to improve the quality of life of patients, and to improve knowledge of cough in general. This review aims to describe the prevalence, impact, pathophysiology and management of CC in asthma, COPD, bronchiectasis, ILD and sarcoidosis.

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“…Little is known about mechanisms of cough in sarcoidosis patients. Consequences of granulomatous inflammation on airway sensory nerves together with the airway obstruction and hyperresponsiveness, concentration, function, and polymorphisms of ACE, and tissue remodelling, bronchiectasis, and fibrosis are discussed as potential cough triggers [10].…”

Section: Introductionmentioning

confidence: 99%

Retrospective Study of Factors Potentially Influencing Occurrence of Cough in Slovak Patients with Sarcoidosis

Kováčová

Vyšehradský

Kocan

et al. 2019

Canadian Respiratory Journal

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Introduction. Sarcoidosis is a multisystem granulomatous disease of unknown aetiology, commonly involving the lungs.  Cough is a frequent and troublesome symptom of sarcoidosis that reduces patients’ quality of life. Aim. Retrospective analysis of different factors—smoking history, Scadding stage, results of lung function testing, calcium metabolism, endobronchial finding, CD4+/CD8+ T-cell ratio in bronchoalveolar lavage fluid (BALF), and other sarcoidosis symptoms in relationship to presence/absence of cough in sarcoidosis patients. Methods. We retrospectively studied sarcoidosis patients diagnosed at the Clinic of Pneumology and Phthisiology of Martin University Hospital between 1998 and 2018. Patients with a history of cough-relevant comorbidities were excluded from the study. GraphPad Prism 7.0 software was used to perform statistical analysis. Results. 101 sarcoidosis patients were included to the study: 65 patients reporting from cough and 36 without cough. The cough was slightly more frequent in nonsmokers (p=0.166) and in women (p=0.688). Cough was associated with dyspnoea (p=0.0007), fever (p=0.0324), and chest pain (p=0.0206) and did not associate with arthralgia (p=0.317) and erythema nodosum (p=0.505). Patients with cough had significantly a lower average value of calciuria (p=0.0014) and lower MEF25 (p=0.0304), MEF50 (p=0.0061), FEV1 (p=0.0025), and FVC (p=0.0025) in % of predicted values, and more often positive endobronchial finding (p=0.0206), compared to patients without cough. Calcemia, FEV1/FVC, DLCO, and CD4+/CD8+ T-cell ratio in BALF and occurrence of cough did not differ between different stages of the disease. Conclusions. We found significant differences between sarcoidosis patients with/without cough regarding symptoms, results of lung function tests, endobronchial finding, and calcium metabolism. Further research is needed to understand the etiopathogenesis of cough in sarcoidosis patients.

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Cough in sarcoidosis patients

Cited by 6 publications

References 96 publications

The Symptoms of Pulmonary Sarcoidosis

The Symptoms of Pulmonary Sarcoidosis

Cough in chronic lung disease: a state of the art review

Retrospective Study of Factors Potentially Influencing Occurrence of Cough in Slovak Patients with Sarcoidosis

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