SELECTED ARTICLES FROM THE RECENT LITERATURE 2005

10/18/05

Chronic cough in interstitial lung disease

Summary
Background - While dyspnea is the most common symptom in those with interstitial lung disease (ILD), chronic cough (CC) can also be frequent and distressing in patients with ILD. But is the ILD responsible for the CC?

Findings - Madison and Irwin reviewed their extensive experience in patients with ILD and CC. They found that, in over 50% of such cases, the CC was due not mainly to the ILD but to the more common conditions associated with CC such as reactive airways disease (asthma equivalent), post-nasal discharge (now called "upper airways cough syndrome") and GERD. In the other ILD patients, it appears that the CC is due to this lung condition, and may respond to treatment of a specific underlying cause of the ILD if one can be identified.

Reference
Curr Opin Pulm Med 2005;11:412-16

Editor's Comments
This discussion is by one of the most prolific author groups dealing with CC. As previously reviewed by me, these authors feel that asthma, upper airway cough syndrome and GERD are responsible for most cases of dry CC in non- smokers with a negative chest x-ray. They now extend such conclusions to patients with ILD. It is important to distinguish the cause of CC in those with ILD, since corticosteroid treatment may benefit the asthma equivalent and the , upper airway cough syndrome; however, such corticosteroid treatment does not benefit idiopathic pulmonary fibrosis, the most common ILD (at least in the older population).

 

<-- BACK