OUTCOME OF COUGH VARIANT ASTHMA TREATED WITH INHALED STEROIDS

Background: Cough variant asthma is defined as a persistent nonproduct ive cough with minimal wheezing or dyspnea. The uncontrolled coughing may interfere with sleep, work, and social activities. Cough precipita ting fecal or urinary incontinence can be extremely distressing. The d iagnosis is established within 1 to 2 weeks by a trial of prednisone, 30 mg a day. The cough will be controlled within that time and subsequ ent management can consist of inhaled corticosteroids. Objective: To e valuate the course often patients with cough variant asthma and their response to inhaled corticosteroids. Methods: Retrospective analysis o f the presentation, diagnosis, course, and response to oral and inhale d steroids in ten patients with cough variant asthma.Results: Ten pati ents whose chief complaint was persistent debilitating cough for perio ds of 2 months to 20 years underwent a diagnostic and therapeutic tria l of prednisone as previously described. At a mean follow-up period of 28 months all were free of debilitating cough. Eight of ten patients were still receiving inhaled steroids and two needed low dose alternat e day oral steroid therapy. Two patients had complete remission of sym ptoms, None required daily inhaled or oral bronchodilators and there w ere no hospital admissions for respiratory symptoms. Conclusions: Inha led corticosteroid therapy after a diagnostic trial of oral steroids i s effective for long-term control of cough variant asthma.