Rhinitis, sinusitis, and upper airway diseaseChronic cough and irritable larynx
Section snippets
Methods
All the consecutive patients who presented with CC as their main symptom in the period between January 2002 and June 2008 and had normal spirometric and chest radiographic results were enrolled in the study. The exclusion criteria were as follows: severe systemic illnesses; known bronchopulmonary diseases; acute respiratory tract infections in the last 2 months; treatment with H1- and H2-antihistaminic, antitussive drugs, bronchodilators, oral corticosteroids, or ICSs in the last month, and
Results
According to the diagnostic criteria, the distribution of the 372 patients within each class was as follows: PR/CRS, 208 (56%) patients, 123 with PR and 85 with CRS; GERD, 62 (17%) patients, 51 with laryngeal involvement; UNEX, 61 (16%) patients; and asthma/CC+, 41 (11%) patients, 39 (95%) with persistent rhinitis, sinusitis, or both.
The general characteristics of the patients in the 4 CC classes and of the 52 asthma/CC− control subjects are compared in Table I. The most significant differences
Discussion
The results of this study indicate that an irritable larynx is very common among patients who present with CC as the main symptom. In fact, most of the 372 patients with CC examined showed LHR, consisting of a dose-dependent decrease in inspiratory flows during histamine challenge. In 164 (44%) patients LHR was the only functional abnormality and would have been missed by recording FEV1 as the response variable.
In agreement with the literature,1, 2, 29 the most common triggers of CC were
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Supported by grants from Regione Piemonte, funds for Applied Scientific Research (2004), and the Italian Ministry of Instruction, University and Research (MIUR, 2002).
Disclosure of potential conflict of interest: The authors have declared that they have no conflict of interest.