Persistent cough in children as a presenting feature of asthma

Abstract

Introduction: Epidemiological studies suggest that the presence of cough indicates a poorer prognosis in children.

Objective: To review the presence of cough as the only respiratory symptom and its eventual relationship with asthma.

Methods and patients: We realized a bibliographic search of reviews and original articles evaluating the presence of persistent cough in children and those suggesting a treatment model for this condition.

Results: Mechanisms of cough and bronchoconstriction are not the same, consequently persistent cough alone is not sufficiently reliable to make the diagnosis of asthma in children. In the majority of cases it is due to a non-specific problem that spontaneously resolves. The elimination of alergens or contamination such as tabacco smoke should be avised, as well as sometimes the use of decongestants or antihistamines for short periods and eventually oral antibiotics. It is recommended that pulmonary function should be measured when possible. There is no evidence to guide the use of inhaled steroids, but on occasions the use of moderately high doses for 8-12 weeks should be advised, if there is no improvement the diagnosis of asthma is improbable.

Conclusions: The majority of children with a persistent cough do not develop asthma, for this reason they do not benefit from the use of inhaled steroids. The use of the word asthma should be used with caution in light of the different phenotypes of asthma in childhood.