Problemi correnti
La tosse (o le tossi)
COUGH
GIORGIO LONGO, EGIDIO BARBI
Clinica Pediatrica, IRCCS “Burlo Garofolo”, Trieste
Dicembre 2000 - pagg. 631 -635
Abstract
Cough is a frequent symptom, ranging from the simple, irritatingly cough associated with
the common cold to the catarrhal cough of sinusitis and to the prolonged afebrile non productive
cough caused by intracellular pathogens such as Mycoplasma and Chlamydia. Cases
of particularly troublesome, recurrent, “untreatable”, nonspecific cough are also commonly
seen by paediatricians. Such cases have increasingly been diagnosed as having
asthma (cough-variant asthma), but epidemiological and clinical evidence suggests that
cough is unlikely to be the only manifestation of asthma. This kind of cough is likely to be
related to an increase of cough receptor sensitivity (CRH). The pathways of the reflex for
cough and bronchoconstriction are distinctly different. Children with cough receptor hypersensitivity
usually start coughing at bedtime and cough is typically unresponsive to treatment,
and getting worse with time: in these children an increase of receptor sensitivity is
probably due to cough itself. Chronic cough (lasting months and particularly if productive
productive) should never be overlooked and requires a thorough diagnostic evaluation including
sweat test and high resolution CT scan. Psychogenic cough is typical of school age
children, it is stereotyped and stops, as a rule, as the child gets asleep.
Suggerite dall'AI
Classificazione MeSH
Bibliografia
1. Ueda D, Yoto Y. The ten-day mark as a
practical diagnostic approach for acute paranasal
sinusitis in children. Pediatr Infect Dis
J 1996;15(7):576-9.
2. Vincent JM, Cherry JD, Nauschuetz WF, et al. Prolonged afebrile nonproductive cough illnesses in American soldiers in Korea: a serological search for causation. Clin Infect Dis 2000;30(3):534-9.
3. Aoyama T, Sunakawa K, Iwata S, Takeuch Y, Fujii R. Efficacy of short term treatment of pertussis with clarithromycin and azithromycin. J Pediatr 1996;129:761-4.
4. Brooke AM, Lambert PC, Burton PR, Clarke C, Luyt DK, Simpson H. The natural history of respiratory symptoms in preschool children. Am J Respir Crit Care Med 1995; 152(6Pt1):1872-8.
5. Brooke AM, Lambert PC, Burton PR, Clarke C, Luyt DK, Simpson H. Recurrent coug: natural history and significance in infancy and early childhood. Pediatr Pulmonol 1998;26:256-61.
6. Faniran AO, Peat JK, Woolcock AJ. Persistent cough: is it asthma? Arch Dis Child 1998;79:411-4.
7. Davies MJ, Fuller P, Piciotto A, McKenzie SA. Persistent nocturnal cough: randomised controlled trial of high dose inhaled corticosteroid. Arch Dis Child 1999:81:38-44.
8. Bernard DW, Goepp JG, Duggan AK, et al. Is oral albuterol effective for acute cough in non-asthmatic children? Acta Paediatr 1999; 88(4):465-7.
9. Chang AB, Phelan PD, Carlin JB, Sawyer SM, Robertson CF. A randomized, placebo controlled trial of inhaled salbutamol and beclometasone for recurrent cough. Arch Dis Child 1998;79:6-11.
10. Chang AB. Cough, cough receptors, and asthma in children. Pediatric Pulmonology 1999;28:59-70.
11. Chang AB. Isolated cough: probably not asthma. Arch Dis Child 1999;80:211-31.
12. Millqvist E. Cough provocation with capsaicin is an objective way to test sensory hyperreactivity in patients with asthm like symptoms. Allergy 2000;55:546-50.
13. Millqvist E, Lowhagen O, Bende M. Quality of life and capsaicin sensitivity in patients with sensory airway hyperreactivity. Allergy 2000;55:540-5.
14. Fujimura M, Sakamoto S, Kamio Y, et al. Effects of methacholine induced bronchoconstriction and procaterol induced bronchodilation on cough receptor sensitivity to inhaled capsaicin and tartaric acid. Thorax 1992; 47(6):441-5.
15. Shimizu T, Mochizuki H, Tokuyama K, et al. Relationship between the acid-induced cough response and airway responsiveness and obstruction in children with asthma. Thorax 1996;51(3):284-7.
16. Wrigt AL, Holberg CJ, Morgan WJ, Taussig LM, Halone M, Martinez FD. Recurrent cough in childhood and its relation to asthma. Am J Respir Crit Care Med 1996; 153(4pt1):1259-65.
17. Nonan TK, Macdonald L, Russel G. Persistent nocturnal cough in childhood: a population based study. Arch Dis Child 1995; 73(5):403-7.
18. Doan T, Patterson R, Greenberger PA. Cough variant asthma: usefulness of a diagnostic- therapeutic trial with prednisone. Ann of Allerg 1992;69:505-9.
19. Hannaway PJ, David G, Hopper K. Cough variant asthma in children. JAMA 1982; 247,2:206-9.
20. Corrao WM, Braman SS, Irwin RI. Chronic cough as the sole presenting manifestation of bronchial asthma. N Engl J Med 1979; 300:633-7
2. Vincent JM, Cherry JD, Nauschuetz WF, et al. Prolonged afebrile nonproductive cough illnesses in American soldiers in Korea: a serological search for causation. Clin Infect Dis 2000;30(3):534-9.
3. Aoyama T, Sunakawa K, Iwata S, Takeuch Y, Fujii R. Efficacy of short term treatment of pertussis with clarithromycin and azithromycin. J Pediatr 1996;129:761-4.
4. Brooke AM, Lambert PC, Burton PR, Clarke C, Luyt DK, Simpson H. The natural history of respiratory symptoms in preschool children. Am J Respir Crit Care Med 1995; 152(6Pt1):1872-8.
5. Brooke AM, Lambert PC, Burton PR, Clarke C, Luyt DK, Simpson H. Recurrent coug: natural history and significance in infancy and early childhood. Pediatr Pulmonol 1998;26:256-61.
6. Faniran AO, Peat JK, Woolcock AJ. Persistent cough: is it asthma? Arch Dis Child 1998;79:411-4.
7. Davies MJ, Fuller P, Piciotto A, McKenzie SA. Persistent nocturnal cough: randomised controlled trial of high dose inhaled corticosteroid. Arch Dis Child 1999:81:38-44.
8. Bernard DW, Goepp JG, Duggan AK, et al. Is oral albuterol effective for acute cough in non-asthmatic children? Acta Paediatr 1999; 88(4):465-7.
9. Chang AB, Phelan PD, Carlin JB, Sawyer SM, Robertson CF. A randomized, placebo controlled trial of inhaled salbutamol and beclometasone for recurrent cough. Arch Dis Child 1998;79:6-11.
10. Chang AB. Cough, cough receptors, and asthma in children. Pediatric Pulmonology 1999;28:59-70.
11. Chang AB. Isolated cough: probably not asthma. Arch Dis Child 1999;80:211-31.
12. Millqvist E. Cough provocation with capsaicin is an objective way to test sensory hyperreactivity in patients with asthm like symptoms. Allergy 2000;55:546-50.
13. Millqvist E, Lowhagen O, Bende M. Quality of life and capsaicin sensitivity in patients with sensory airway hyperreactivity. Allergy 2000;55:540-5.
14. Fujimura M, Sakamoto S, Kamio Y, et al. Effects of methacholine induced bronchoconstriction and procaterol induced bronchodilation on cough receptor sensitivity to inhaled capsaicin and tartaric acid. Thorax 1992; 47(6):441-5.
15. Shimizu T, Mochizuki H, Tokuyama K, et al. Relationship between the acid-induced cough response and airway responsiveness and obstruction in children with asthma. Thorax 1996;51(3):284-7.
16. Wrigt AL, Holberg CJ, Morgan WJ, Taussig LM, Halone M, Martinez FD. Recurrent cough in childhood and its relation to asthma. Am J Respir Crit Care Med 1996; 153(4pt1):1259-65.
17. Nonan TK, Macdonald L, Russel G. Persistent nocturnal cough in childhood: a population based study. Arch Dis Child 1995; 73(5):403-7.
18. Doan T, Patterson R, Greenberger PA. Cough variant asthma: usefulness of a diagnostic- therapeutic trial with prednisone. Ann of Allerg 1992;69:505-9.
19. Hannaway PJ, David G, Hopper K. Cough variant asthma in children. JAMA 1982; 247,2:206-9.
20. Corrao WM, Braman SS, Irwin RI. Chronic cough as the sole presenting manifestation of bronchial asthma. N Engl J Med 1979; 300:633-7