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Woelke S, Szelenyi A, Dreßler M, Trischler J, Donath H, Hutter M, Blümchen K, Zielen S. Methacholine and FeNO Measurement in Patients with Habit Cough. KLINISCHE PADIATRIE 2023; 235:84-89. [PMID: 36720225 DOI: 10.1055/a-2004-3477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Chronic cough is one of the most common symptoms in childhood. Making a definite diagnosis is a challenge for all pediatricians especially in patients when cough is without an organic cause like in habit cough. PATIENTS AND METHODS In this retrospective analysis, all electronic outpatient charts of the Division of Allergology and Pneumology, between January 1, 2010 and December 31, 2019 were reviewed in order to study all children with potential habit cough. All children underwent the following diagnostic algorithms, skin prick test (SPT), measurement of fractional exhaled nitric oxide (FeNO), spirometry and methacholine challenge test (MCT). The value of a normal MCT and FeNO measurement for diagnosing habit cough was investigated. RESULTS The chart review revealed 482 patients with chronic cough>4 weeks. Of these, 99 (20.5%) with suspected habit cough were collected. 13 patients had to be excluded for other diagnosis and a complete data set was available in 55 patients. 33 (60.0%) of 55 patients were SPT negative and 22 (40.0%) had sensitization to common allergens. Five patients had elevated FeNO≥20 ppb and three showed severe bronchial hyperresponsiveness<0.1 mg methacholine, challenging the diagnosis of habit cough. CONCLUSION A normal FeNO and MCT can help confirm the clinical diagnosis of habit cough. However, in patients with positive MCT and/or elevated FeNO habit cough can be present. Especially in patients with elevated FeNO and severe BHR cough variant asthma and eosinophilic bronchitis have to be ruled out.
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Affiliation(s)
- Sandra Woelke
- Department for Children and Adolescence, Division of Allergy, Pulmonology and Cystic fibrosis, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Alexandra Szelenyi
- Department for Children and Adolescence, Division of Allergy, Pulmonology and Cystic fibrosis, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Melanie Dreßler
- Department for Children and Adolescence, Division of Allergy, Pulmonology and Cystic fibrosis, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Jordis Trischler
- Department for Children and Adolescence, Division of Allergy, Pulmonology and Cystic fibrosis, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Helena Donath
- Department for Children and Adolescence, Division of Allergy, Pulmonology and Cystic fibrosis, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Martin Hutter
- Department for Children and Adolescence, Division of Allergy, Pulmonology and Cystic fibrosis, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Katharina Blümchen
- Department for Children and Adolescence, Division of Allergy, Pulmonology and Cystic fibrosis, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Stefan Zielen
- Department for Children and Adolescence, Division of Allergy, Pulmonology and Cystic fibrosis, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
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Chang AB, Oppenheimer JJ, Irwin RS. Response. Chest 2021; 158:1289-1290. [PMID: 32892871 DOI: 10.1016/j.chest.2020.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 04/09/2020] [Indexed: 11/27/2022] Open
Affiliation(s)
- Anne B Chang
- Division of Child Health, Menzies School of Health Research, and the Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Qld Uni of Technology, Brisbane, QLD, Australia.
| | - John J Oppenheimer
- Department of Medicine, UMDNJ-Rutgers, Pulmonary and Allergy Associates, Morristown, NJ
| | - Richard S Irwin
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, UMass Memorial Medical Center, Worcester, MA
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Zacharasiewicz A. Chronischer Husten bei Kindern. Monatsschr Kinderheilkd 2020. [DOI: 10.1007/s00112-020-00961-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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