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Chronic nonspecific isolated cough did not recur in most children

Chronic nonspecific isolated cough did not recur in 71% of children, while the minority of children were diagnosed with asthma, according to study results.

Researchers in Turkey followed 109 children (median age, 5 years) with chronic nonspecific isolated cough (NIC) lasting at least 4 weeks (median cough duration, 12 weeks) for a mean of 21 months. Patients were treated with a wait-and-review approach or 400 mcg budesonide daily for 2 weeks, based on parents’ preference. A validated cough score measured responses; patients with partial response had treatment extended to 8 weeks, and follow-ups occurred every 3 months.

Seventy-seven patients did not experience NIC recurrence, while 31 patients relapsed at a median of 6 weeks. Of the patients who relapsed, 21 were diagnosed with classic asthma and 10 with cough variant asthma. Asthma risk increased with aeroallergen sensitization (RR=2.86; 95% CI, 1.17-6.99) and previous history of chronic cough (RR=2.68; 95% CI, 1.10-6.49).

“Cough duration, the cough score, the family history of asthma, and serum eosinophilia were not found discriminative for the final diagnosis,” the researchers reported.

Response to treatment of 2 weeks or 8 weeks showed no significant differences in patients who eventually developed asthma.

“Initial responses to the ICS [inhaled corticosteroid] trial may be misleading,” the researchers concluded. “A careful follow-up of these children is important so that they are not overdiagnosed with asthma and also in terms of correctly identifying the ones who eventually develop asthma. A wait-and-review approach of at least 2 weeks may be considered initial management for all children with chronic NIC. A trial with ICS may be preferred for children who have atopic sensitization, a previous history of cough, or both.”

Disclosure: The researchers report no relevant financial disclosures.