title: A prospective longitudinal study of clinical characteristics, laboratory findings, diagnostic spectrum and outcomes of specific therapy in adult patients with chronic cough in a general respiratory clinic.
abstract: Chronic cough with established diagnostic protocols has been well described in secondary and tertiary centres. Little information is available about adult patients to a general respiratory clinic where no such protocols exist. The objective of this study is to determine clinical characteristics, laboratory findings, diagnostic spectrum and outcomes of specific therapy in adult patients with chronic cough in a general respiratory clinic. In this prospective, longitudinal, descriptive study for patients with chronic cough defined as more than 8 weeks, we studied, according to a questionnaire, chest radiography, spirometry and reversibility, methacholine challenge and other measures. Treatment was prescribed on the basis of diagnosis informed by investigation results.We evaluated 147 patients (102 females) of a mean age of 48 years and complaining of cough an average of 24 weeks. On the basis of a successful response to treatment, the causes of cough were determined in 92% and the frequencies were asthma in 39%, COPD in 11%, chronic upper airway cough syndrome (CUACS) in 9%, gastro-oesophageal reflux disease (GERD) in 9% and no diagnosis in 8%. Cough was due to one condition in 82%. Our treatment success rate was 92%. The most frequent causes of chronic cough (asthma, COPD, CUACS and GERD) could be determined in a general respiratory clinic with a sequential approach. The frequencies are different from those in a tertiary cough clinic, but outcome of specific therapy is successful in our patients.
authors.affiliation: Respiratory Division, Department of Medicine, Federal University of São paulo (UNIFESP), São paulo, Brazil. marcospneumo@ig.com.br
authors.forename: M
authors.initials: M
authors.lastname: Ribeiro
authors.forename: C A
authors.initials: CA
authors.lastname: De Castro Pereira
authors.forename: L E
authors.initials: LE
authors.lastname: Nery
authors.forename: O S
authors.initials: OS
authors.lastname: Beppu
authors.forename: C O S
authors.initials: CO
authors.lastname: Silva
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001249:Asthma / Q000150:complications; D001985:Bronchial Provocation Tests; D029481:Bronchitis, Chronic / Q000150:complications; D016085:Bronchoconstrictor Agents; D002908:Chronic Disease; D003371:Cough / Q000209:etiology / Q000628:therapy*; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D016210:Methacholine Chloride; D008875:Middle Aged; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D013147:Spirometry; D016896:Treatment Outcome
chemical_list: D016085:Bronchoconstrictor Agents; D016210:Methacholine Chloride