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Allergic cough

Allergic cough

Allergic cough

Allergic cough (AC) as an independent disease has not yet been recognized. The definition of it is currently only in the descriptive stage, lacking a large number of systematic research observations. It mainly refers to some patients with chronic cough clinically, with some Atopic factors, antihistamines and glucocorticoid therapy are effective, but can not be diagnosed as asthma, allergic rhinitis or eosinophilic bronchitis (EB) should not be classified as other diseases for the time being. This type of cough is defined as AC. Its relationship with allergic laryngitis, EB, and cough after a cold, etc. need to be further explored to determine whether it is an independent disease entity.

Allergic cough is mostly caused by viral infection that persists and is complicated by bacterial infection, and allergic factors are involved. Paroxysmal irritating dry cough caused by itching is the main manifestation.

The concept of allergic cough was first proposed by Japanese scholar Fujimurat in 1992. Mainly refers to patients with dry cough who have poor treatment with bronchodilators but effective antihistamines and glucocorticoids. They have certain special symptoms and normal sputum eosinophils. It is often accompanied by itching symptoms. The etiology of the disease is not very clear, there is no unified diagnostic standard, and early clinical manifestations are difficult to distinguish from ordinary acute upper respiratory infections, causing most patients to delay diagnosis and improper treatment.

Diagnostic criteria

1 Chronic cough.

2 Lung function is normal, airway hyperresponsiveness test is negative.

3 Has one of the following characteristics (1) history of exposure to allergens (2) positive allergen skin test (3) total serum IgE or characteristic IgE increased. (4) Increased cough sensitivity.

4 rule out CAV, upper airway cough syndrome, EB and other causes of chronic cough.

5 Glucocorticoids or amines are effective.

The current more systematic and detailed diagnostic criteria were proposed by the Japanese Cough Research Association, as follows:

The dry cough is longer than 8 weeks, and there is no wheezing or dyspnea;

There is more than one allergic constitution including the past history of allergic diseases and / or comorbidities, but to exclude asthma, peripheral blood eosinophils (6% or 400 / IA), total serum Increased IgE levels (200 IU / m1), positive specific pollen antibodies and positive skin allergen stimulation tests, and / or induced eosinophils in sputum (2.5%);

The bronchial reversibility test was negative. FEV was determined by inhaling 300 mg of salbutamol. Increase 10%;

Normal bronchial reactivity, methacholine challenge test (provoking concentration, PC) caused FEV. It is normal for the concentration (PC20) 10 mg / ml to decrease 20%;

Increased cough reflex sensitivity (concentration of capsaicin challenge test 3.9 / -moL / L;

Bronchodilator therapy is ineffective, oral Clenbuterol 40 Ixg / d plus inhalation of procaterol or salbutamol before bedtime or if necessary for 1 week;

Chest radiograph does not indicate abnormality (this abnormality can indicate the cause of cough);

Normal FEV, value (80% expected value), FVC 80% expected value, and FEV, / FVC ratio 70%).