Chronic productive cough in young adults is very often due to chronic rhino-sinusitis.
BACKGROUND
Chronic productive cough is a common clinical problem; often potential causes outside the lower respiratory tract are forgotten or ignored. The aim of this study was to make a precise etiopathogenetic diagnosis of chronic productive cough in young adults.


METHODS
In a clinical setting, 212 subjects (mean age 41+/-5 years) who had reported chronic productive cough in a previous postal survey of a young adult population underwent within two years clinical and functional investigations following a rational diagnostic approach. Two pulmonologists independently established the diagnosis using a clinically structured interview on nasal and respiratory symptoms, spirometry and other tests when appropriate (bronchodilator test or methacholine bronchial challenge, chest radiography); if rhino-sinusitis was suspected, subjects underwent an ENT examination with nasal endoscopy and/or sinus computed tomography.


RESULTS
At the end of the diagnostic procedure, 87 subjects (41%) no longer had chronic productive cough and had normal function. Fifty-eight subjects (27%) had chronic rhino-sinusitis; seventeen subjects (8%) had asthma, and of these fourteen also had chronic rhino-sinusitis; 50 subjects (24%) had COPD stage 0+, of these seven also had chronic rhino-sinusitis. Chronic rhino-sinusitis was more frequent in females than in males (p<0.05).


CONCLUSIONS
Both in clinical practice and in epidemiological studies, it is important to consider that the origin of chronic productive cough could be frequently outside the lower respiratory tract; a consistent percentage of young adults with persistent productive cough has indeed chronic rhino-sinusitis.
Corsico
A G
AG
Division of Respiratory Diseases, IRCCS Policlinico San Matteo, University of Pavia, Italy. angelo.corsico@unipv.it
Villani
S
S
Zoia
M C
MC
Niniano
R
R
Ansaldo
E
E
Cervio
G
G
Quaresima
P M
PM
Gatto
E
E
Crippa
E
E
Marinoni
A
A
Foresi
A
A
Pozzi
E
E
Cerveri
I
I
D000328:Adult; D001249:Asthma / Q000150:complications / Q000175:diagnosis; D002908:Chronic Disease; D003371:Cough / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000175:diagnosis; D012129:Respiratory Function Tests; D012220:Rhinitis / Q000150:complications* / Q000175:diagnosis*; D012852:Sinusitis / Q000150:complications* / Q000175:diagnosis*; D013183:Sputum