title: Posttussive emesis as a symptom of asthma in children.
abstract: BACKGROUND
  Emesis can be triggered by cough in children, and cough is a common symptom of asthma.
  
  
  OBJECTIVE
  To explore the association between posttussive emesis and asthma in the pediatric population.
  
  
  METHODS
  A questionnaire was distributed to parents of children between the ages of 2 and 17 years in the pediatric and allergy-immunology clinics at our institution from August 16 through November 3, 2008. Prevalence of posttussive emesis was determined and compared among children with physician-diagnosed asthma, children with no evidence of asthma, and those not formally diagnosed as having asthma but with surrogate markers suggestive of asthma. The predictive value of posttussive emesis was compared with those of known markers of asthma. The prevalence of gastroesophageal reflux and pertussis was evaluated because these conditions might also cause posttussive emesis.
  
  
  RESULTS
  The prevalence of posttussive emesis was 33% in our study population of 500 children. Among those with physician-diagnosed asthma (n = 122), 56% reported a history of posttussive emesis. For patients not formally diagnosed as having asthma but with surrogate markers suggestive of asthma (n = 62), 71% had a history of posttussive emesis. Both of these were significantly higher than in those with no evidence of asthma (n = 316), in whom 16% reported a history of posttussive emesis (P < .0005). Children with posttussive emesis were significantly more likely to have asthma than those without posttussive emesis (odds ratio, 7.9; 95% confidence interval, 5.2-12). Neither pertussis nor gastroesophageal reflux accounted for the degree of posttussive emesis reported.
  
  
  CONCLUSIONS
  Posttussive emesis is more common among children with asthma than among nonasthmatic children. In children with cough and a history of posttussive emesis, asthma should be strongly considered in the differential diagnosis.
authors.affiliation: Walter Reed Army Medical Center, Washington, DC, USA. joseph.c.turbyville@us.army.mil
authors.forename: Joseph
authors.initials: J
authors.lastname: Turbyville
authors.forename: Satyen
authors.initials: S
authors.lastname: Gada
authors.forename: Kathryn
authors.initials: K
authors.lastname: Payne
authors.forename: Susan
authors.initials: S
authors.lastname: Laubach
authors.forename: Charles W
authors.initials: CW
authors.lastname: Callahan
authors.forename: Michael
authors.initials: M
authors.lastname: Nelson
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications; D006801:Humans; D008297:Male; D011795:Surveys and Questionnaires; D014839:Vomiting / Q000209:etiology*; D014917:Whooping Cough / Q000150:complications*