We investigated the prevalence of bronchial hyperreactivity and atopic state in patients with chronic cough to see the cause and clinical significance of those factors in chronic cough.
Methods
We studied 92 individuals who had presented with paroysmal cough over 3 weeks without dyspnea or wheezing. Methacholine bronchial provocation test and allergic skin test with paranasal sinus X ray, symptoms, serum lgE levels and peripheral eosinophils were measured and analyzed.
Results
1) Forty eight percent of patients showed positive hyperreactivity to methacholine provocation, 11 percent had postnasal drip syndrome and 9 percent had both of them, Three precent of patients were thought to have gastroesophageal reflux. However 29% has do specific causes for their cough.
2) Forty four percent of patients were atopic patients and others were non-atopics. There were no significant differences of symptom score, serum lgE levels and peripheral eosinophil count between the two groups.
3) Sixty two percent of atopic patients and 40 percent of non-atopic patient were cough variant asthma with positive reaction to methacholine provocation test. However there was no significant difference of mean PC20 of methacholine between the two group.
Conclusion
These results indicated that airway responsiveness and atopic started are important factors for chronic cough. However they were not predictable on the basis of clinical and ordinary laboratory findings.
Spontaneous pneumomediastinum is an uncommon disease that is defined as the presence of free air in the mediastinum in the absence of any obvious precipitating cause. This condition occurs as a rare complication of acute exacerbation of asthma. Classic symptoms include retrosternal chest pain, dyspnea and cough, but are not specific. Spontaneous pneumomediastinum complicated by asthma is usually self-limiting and well controlled with conservative management, but this condition can be potentially life threatening. We report a case of 18-year-old woman with asthma who presented with spontaneous pneumomediastinum. The patient was treated conservatively with oxygen and steroid therapy, and her clinical conditions were improved. Spontaneous pneumomediastinum disappeared.