Chronic cough related to the upper airway cough syndrome: one entity but not always the same
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RHINOLOGY
Chronic cough related to the upper airway cough syndrome: one entity but not always the same Marta Dąbrowska1 · Magdalena Arcimowicz2 · Elżbieta M. Grabczak1 · Olga Truba1 · Aleksandra Rybka1 · Katarzyna Białek‑Gosk1 · Karolina Klimowicz1 · Barbara Jamróz2 · K. Niemczyk2 · Rafał Krenke1 Received: 6 April 2020 / Accepted: 19 May 2020 © The Author(s) 2020
Abstract Purpose Upper airway cough syndrome (UACS), described as chronic cough (CC) associated with allergic (AR), non-allergic rhinitis (NAR) or chronic rhinosinusitis (CRS), is one of the major causes of CC. We aimed to characterize a cohort of UACS patients with special attention to differences between patients with AR and NAR. Methods A prospective analysis of clinical data of patients, diagnosed with UACS between 2015 and 2018. Results There were 143 patients diagnosed with UACS, median age 52 years, women predominance (68.5%), The group comprised of 59 (41%) AR and 84 (59%) NAR subjects, CRS diagnosed in 17 (12%). Median cough duration: 48 months (IQR 24–120), median cough severity (VAS)—60 mm (IQR 42–78), median Leicester Cough Questionnaire (LCQ) score—11.3 (IQR 8.7–13.7), never-smokers: 70%. The most common symptoms: PND (62%), rhinorrhea (59%), nasal congestion (54%), abnormalities of sinus CT: septum deviation (62%), turbinates hypertrophy (53%), mucosal thickening (53%). UACS as the only cause of CC, was presented in 20 patients (14%). We found no differences between patients with AR and NAR in terms of age, gender, duration and severity of cough, BMI, blood eosinophil count, total IgE and FeNO. AR was associated with higher comorbidity of asthma than NAR (54% vs 35%, p = 0.019). Abnormalities in sinus CT scan were more frequently found in patients with NAR than AR (p = 0.018). Conclusion NAR is the most common upper airway disease associated with UACS. Clinical characteristics of UACS patients with AR and NAR are similar with only minor differences between these groups. It seems reasonable to plan further studies concerning relationship of NAR and cough sensitivity, also in terms of potential similar neurogenic mechanism. Keywords Chronic cough · Upper airway cough syndrome · Allergic rhinitis · Non-allergic rhinitis · Rhinosinusitis
Introduction Chronic cough affects 4–10% of the adult population and, in a significant proportion of patients, it may significantly deteriorate quality of life [1, 2]. The most common cause of chronic cough is smoking-related bronchitis, while in nonsmoking patients, chronic cough is usually related to gastroesophageal reflux (GER), asthma, upper airway diseases, chronic lung disease and medications, including angiotensin * Magdalena Arcimowicz [email protected] 1
Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Warsaw, Banacha 1A, 02‑097 Warsaw, Poland
2
convertase inhibitors (ACEI) [3–6]. Chronic cough associated with different upper airway dise
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