This article is written by dr.Aditya, a doctor at Kizuna Clinic.
Cough-variant asthma (CVA) is a form of asthma in which coughing is the main symptom, without wheezing, chest tightness, or shortness of breath. It is one of the leading causes of chronic or prolonged cough, estimated to account for 25% to 42% of cases, although it is likely underdiagnosed due to delayed recognition and pitfalls of diagnostic testing. Early identification and treatment can lessen complications and slow its progression to more typical asthma.
Clinical Characteristics:
• Persistent cough lasting more than 8 weeks, especially at night or after physical activity.
• No wheezing or shortness of breath, which are typical in regular asthma.
• The patient may experience irritation or itching in the throat, and the cough may worsen when exposed to cold weather or smoke.
• It leads to a persistent or recurring dry cough that improves with asthma treatments, such as inhalers.
Diagnosis:
• Diagnosing CVA is more difficult because its symptoms are similar to other respiratory conditions.
• Doctors usually perform lung function tests (such as spirometry), allergy tests, and sometimes tests to check the response to asthma treatment.
• Additional tests may be required to ensure the cough is not caused by other conditions, such as infections or GERD (gastroesophageal reflux disease).
Disease Process:
• In CVA, the airways become sensitive and irritated, but the inflammation is less severe than in regular asthma.
• When exposed to triggers such as cold air, pollution, or allergens, the airways become irritated and cause coughing as the body’s response.
• Although wheezing or shortness of breath is not typically present, inflammation still occurs in the airways.
Why It's Important to Seek Medical Help Early
• CVA is often overlooked because its main symptom is chronic coughing, which could be mistaken for other conditions such as the flu or allergic cough.
• Ignoring these symptoms without a proper diagnosis can worsen the condition and lead to long-term respiratory issues.
• Early detection and proper treatment are crucial to prevent the development of more severe asthma and other complications.
Therefore, if you experience a persistent cough that does not improve or worsens, it is important to consult a doctor so the condition can be properly managed.
References:
1. Cox JK, Lockey R, Cardet JC. Cough-Variant Asthma: A Review of Clinical Characteristics, Diagnosis, and Pathophysiology. The Journal of Allergy and Clinical Immunology: In Practice. 2024 Nov;S221321982401170X.
2. Niimi A. Cough and Asthma. CRMR. 2011 Feb 1;7(1):47–54.
3. Zhan W, Wu F, Zhang Y, Lin L, Li W, Luo W, et al. Identification of cough-variant asthma phenotypes based on clinical and pathophysiologic data. Journal of Allergy and Clinical Immunology. 2023 Sep;152(3):622–32.
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