Ten Years of Chronic Cough in a 64-Year-Old Man With Multiple Pulmonary Nodules.
A 64-year-old male former smoker with a history of prostate cancer presented to our pulmonary clinic, complaining of nonproductive cough for 10 years. Prior evaluation included treatment for upper airway cough syndrome and gastroesophageal reflux, stopping angiotensin-converting enzyme inhibitor, and initiation of inhaled β-agonists. Esophageal pH monitoring indicated silent reflux, and proton pump inhibitor therapy was started. He continued to cough and complain of dyspnea. Physical examination produced unremarkable results, with no evidence of lymphadenopathy. Pulmonary function tests showed a pseudo-restrictive pattern with air trapping, hyperreactivity, and incomplete bronchodilator responsiveness: FEV1, 2.48 L (69% of predicted); FVC, 3.57 L (75% of predicted); FEV1/FVC, 92%; total lung capacity, 7.00 L (100% of predicted); and residual volume, 3.05 L (136% of predicted). Laboratory studies, including a complete metabolic panel, prostate-specific antigen test, and complete blood count, yielded normal results.
Department of Pulmonary and Critical Care, Walter Reed National Military Medical Center, Bethesda, MD. Electronic address: Whittney.Warren@gmail.com.
Whittney A
WA
Warren
Department of Radiology, Walter Reed National Military Medical Center, Bethesda, MD.
Scott S
SS
Dalane
Uniformed Services University of the Health Sciences, Bethesda, MD.
Bryce D
BD
Warren
Department of Radiology, Walter Reed National Military Medical Center, Bethesda, MD.
Paul G
PG
Peterson
Department of Pathology, Walter Reed National Military Medical Center, Bethesda, MD.
Rodney D
RD
Boyum
Department of Pulmonary and Critical Care, Walter Reed National Military Medical Center, Bethesda, MD.
William
W
Kelly
D002276:Carcinoid Tumor / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D002908:Chronic Disease; D003371:Cough / Q000209:etiology; D004417:Dyspnea / Q000209:etiology; D019788:Fluorodeoxyglucose F18; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008175:Lung Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D055613:Multiple Pulmonary Nodules / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012115:Residual Volume; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014109:Total Lung Capacity; D014797:Vital Capacity
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18