Cough Variant Asthma in Medical Outpatient Department of a Tertiary Care Hospital in Bangladesh

Rukhsana Parvin,Shekhar Bhattacharjee,Swapna Bhattacharjee

doi:10.3329/jemc.v3i1.13871

Abstract

Background: Cough variant asthma (CVA) is a subset of asthma where the only symptom is chronic persistent cough. Many cases go unrecognized due to lack of proper evaluation. Response to asthma medication with features supportive of airway hypersensitivity helps in management of this disease. Objective: To find out the proportion of cough variant asthma among the patients attending medicine outpatient department of Enam Medical College, Savar, Dhaka. Materials and Methods: This cross sectional study was conducted in Enam Medical College Hospital, Savar, Dhaka over a period of two years from July 2009 to July 2011. Cough variant asthma was diagnosed mainly on clinical ground as chronic cough without wheezing, fever, weight loss, shortness of breath or sputum or any other apparent cause that persisted for more than eight weeks with absolutely normal physical examination of chest, normal chest radiography and blood count except raised eosinophil count and IgE level. Patients who met these criteria were given 2 weeks course of inhaler beclomethasone propionate and were assessed for improvement. Those who improved after steroid inhalation were categorised as having cough variant asthma. Results: Out of purposively selected 148 patients complaining only of chronic dry cough for more than eight weeks, 92 patients met the primary selection criteria for cough variant asthma. These 92 patients were given 2 weeks trial of 250 ìgm beclomethasone inhalation twice daily. Seventy nine patients reported almost complete recovery from chronic cough after 2 weeks and were categorized as having CVA. Thirteen patients did not improve and were not categorized as CVA. Conclusion: These findings suggest that cough variant asthma is the most common among the patients with chronic cough not due to any apparent cause. The efficacy of inhaled corticosteroid suggests that early intervention is effective in the treatment of this disease. DOI: http://dx.doi.org/10.3329/jemc.v3i1.13871 J Enam Med Col 2013; 3(1): 29-31

Highlights

Cough is one of the most common symptoms described by patients attending medicine outpatient clinic in general hospitals in Bangladesh
Bronchial asthma and cough variant asthma (CVA) comprise the major bulk of otherwise healthy patients complaining of chronic nonproductive cough besides other causes like post-infection post nasal drip syndrome (PNDS) and cough associated with gastroesophageal reflux disease (GERD).[1,2,3]
Cough variant asthma (CVA) can be considered as a subtype of bronchial asthma and about 25% of CVA patients seem to develop clinically full-blown bronchial asthma

Summary

Introduction

Cough variant asthma was diagnosed mainly on clinical ground as chronic cough without wheezing, fever, weight loss, shortness of breath or sputum or any other apparent cause that persisted for more than eight weeks with absolutely normal physical examination of chest, normal chest radiography and blood count except raised eosinophil count and IgE level. Patients who met these criteria were given 2 weeks course of inhaler beclomethasone propionate and were assessed for improvement. The efficacy of inhaled corticosteroid suggests that early intervention is effective in the treatment of this disease

Objectives

Methods

Conclusion