Wheezing cough
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Summary
10 papers analyzed
These studies suggest that wheezing cough in children is associated with asthma, distinct wheeze phenotypes, risk factors like rhinitis and environmental triggers, and can be managed with bronchodilators or inhaled corticosteroids.
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Understanding Wheezing and Cough: Insights from Recent Research
Wheezing and Cough in Cough Variant Asthma (CVA)
Cough variant asthma (CVA) is characterized by a persistent cough without the wheezing typically associated with asthma. However, a significant number of CVA patients eventually develop wheezing. Research indicates that this transition is linked to an increase in airway hyperresponsiveness rather than a decrease in the threshold for wheezing. In a study involving 36 children with CVA, those who developed wheezing showed a significant decrease in methacholine PD20 values, indicating increased airway hyperresponsiveness, while their wheezing thresholds remained unchanged.
Phenotypes of Childhood Wheeze and Cough
Childhood wheeze and cough exhibit diverse clinical presentations and progressions. A study validating phenotypes of wheeze and cough identified two consistent phenotypes across different cohorts: atopic persistent wheeze and transient viral wheeze. Atopic persistent wheeze is associated with chronic symptoms, atopy, reduced lung function, and poor prognosis, while transient viral wheeze is characterized by early onset, viral triggers, and a favorable prognosis. These findings suggest distinct disease processes for these phenotypes.
Prevalence and Impact of Wheeze and Cough in Children
Epidemiological studies have highlighted the prevalence and impact of wheeze and cough in children. In a survey of preschool children, 11% had been diagnosed with asthma, and 15.6% experienced wheezing, with higher rates in boys. Recurrent cough without colds was reported in 21.8% of children. These symptoms significantly affect daily life, including school attendance, with respiratory symptoms being a major cause of school absenteeism .
Side Effects of Beclomethasone Aerosol
Beclomethasone dipropionate aerosol (BA), a common asthma treatment, can cause cough and wheezing in some patients. A study found that 20% of asthmatic patients experienced severe cough and wheezing after inhaling BA. Pretreatment with bronchodilators was effective in reducing these side effects for some patients, while others required a short course of oral steroids.
Nocturnal Cough and Wheezing in Acute Bronchitis
In children with acute bronchitis, nocturnal cough and wheezing are predominant symptoms. Objective monitoring of these symptoms over several nights showed a significant reduction in cough and wheezing frequency over time. This method provides a valuable tool for evaluating the effectiveness of treatments for bronchitis symptoms.
Rhinitis and Its Association with Recurrent Cough and Wheezing
Rhinitis has been identified as an independent risk factor for both recurrent cough and wheezing in children. A longitudinal study found that children with rhinitis had a higher risk of experiencing both symptoms, suggesting that different pathways may be involved in the association of rhinitis with these respiratory issues.
Risk Factors for Chronic Cough and Wheezing
Various environmental and lifestyle factors contribute to chronic cough and wheezing in children. A study identified smoke, steam, dust, flowers, plants, cold air, and certain foods as common triggers. These findings emphasize the importance of managing environmental exposures and lifestyle factors to reduce respiratory symptoms in children.
Differentiating Asthma from Other Causes of Cough and Wheezing
Not all cases of cough and wheezing are due to asthma. Conditions such as pertussis, cystic fibrosis, and vocal cord dysfunction can mimic asthma symptoms. Accurate diagnosis through careful history, spirometry, and other tests is crucial to avoid inappropriate treatment and ensure proper management of these conditions.
Conclusion
Wheezing and cough in children are complex symptoms with various underlying causes and risk factors. Understanding the distinct phenotypes, environmental triggers, and associated conditions is essential for accurate diagnosis and effective management. Continued research and objective monitoring methods are vital for improving outcomes for children with these respiratory symptoms.
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