Effect of Bronchodilator and Corticosteroid Inhalation Therapy in Cough Variant Childhood Asthma

Pyun, Bok Yang; Ban, Sung Hwan; Kim, Sang Hyun

Abstract

PURPOSE
Cough variant asthma may be defined as a presentation of asthma that fulfills all the criteria of asthma, inflammatory process of the airways and airway hyperresponsiveness. Because of the cough is only the manifestation in cough variant asthma especially in children, it may be very difficult to assess by the physical examination and routine spirometry. Airway function may be further evaluated by bronchial provocation, usually with methacholine or exercise, to supprot or exclude the diagnosis of asthma. In children too young to perform pulmonary function tests, a therapeutic trial can serve as a diagnostic tool. In this study we evaluate the effectiveness of inhaled bronchodilator and corticosteroid treatment to the children with cough variant asthma.
METHODS
Forth-eight children who visited to our pediatric allergy clinic having a chronic cough more than 3 weeks were enrolled to our study. We defined a children who showed bronchial hyperresponsiveness after exercise challenge as a cough variant asthma. We analyzed the changes of PEFR before and after exercise and treatment for 4 weeks.
RESULTS
1) All the patients with cough variant asthma or sinobronchitis have a night aggravating cough as a sole manifestation. 2) The baseline % predicted PEFR showed within normal range in the study subjects. But there was significant decrease of % perdicted PEFR after execise challenge in the patients with cough variant asthma. 3) There was significant increase of % predicted PEFR after treatment with inhaled bronchodilator and corticosteroid in the patients with cough vatiant asthma. Also it is noted in the patients with sinobronchitis treated with antibiotics.
CONCLUSION
We can find significant improvement of clinical manifestation and pulmonary function in the patients with cough variant asthma who treated with inhaled bronchodilator and corticosteoid. Because of many children suffering from chronic cough may have a cough variant asthma, we emphasized that inhaled bron-chodilator and corticosteroid treatment is effective for long-term control of cough variant asthma.