Evaluation of patients with chronic cough in school age children

Öz

Introduction: Chronic cough is a common problem in childhood. Simple viral infections can cause chronic cough, as well as underlying progressive diseases. For this reason, guidelines that can be applied in clinical practice are very valuable. In our study, we aimed to evaluate our school-age patients with chronic cough in the light of the literature. Material Method: The files of children over the age of 6 who applied to the pediatric allergy outpatient clinic between January 2022 and June 2022 with cough for more than 4 weeks were evaluated retrospectively. Results: 182 patients aged 6-17.9 years were included in the study. 62.1% of the patients were male, the mean age was 9.8±3.8 years. 32.4% of our patients had asthma; 43.4% Upper airways cough syndrome (20.9% sinusitis, 17.6% allergic rhinitis, 4.9% non-allergic rhinitis); 7.68% Protracted bacterial bronchitis; 6.59% postinfectious cough; 4.9% of our patients had psychogenic cough; 2.2% Gastroesophageal reflux disease; 1.1% patients had brochiectasis; 1.1% of patients had primary ciliary dyskinesia; 0.55% of the patients were diagnosed with eosinophilic esophagitis. Conclusion: Chronic cough in childhood can be caused by many different underlying diseases. It is observed that patients often use drugs such as antibiotics and symptom relievers unnecessarily. Accurate evaluation of patients, especially taking a detailed history, is very important in the management of these cases. It is very valuable to evaluate each patient individually.

Anahtar Kelimeler

• asthma, childhood, etiological evaluation, chronic cough

Okul çağı kronik öksürük yakınması ile gelen hastaların değerlendirilmesi

Öz

Giriş: Kronik öksürük çocukluk çağında sık karşılaşılan bir sorundur. Basit viral enfeksiyonlar kronik öksürüğe sebep olabileceği gibi altta yatan ilerleyici hastalıklarda buna sebep olabilmektedir. Bu sebeple klinik pratikte uygulanabilecek rehberler oldukça kıymetlidir. Çalışmamızda kronik öksürük yakınması olan okul çağı hastalarımızı literatür ışığında değerlendirilmeyi amaçladık. Gereç ve Yöntemler: Ocak 2022 - Haziran 2022 arasında çocuk alerji polikliniğine 4 haftadan uzun süredir öksürük sebebiyle başvuran 6 yaş üstü çocukların dosyaları retrospektif olarak değerlendirildi. Sonuç: 6-17.9 yaş arasında 182 hasta çalışmaya dahil edildi. Hastaların % 62,1 erkek, yaş ortalaması 9.8± 3.8 yıldı. Hastalarımızın %32.4’e astım; %43,4 Üst havayolları kaynaklı öksürük sendromu (%20,9 sinuzit, %17,6 alerjik rinit,% 4,9 non-alerjik rinit); %7,68 uzamış bakteriyel bronşit; %6,59 postenfeksiyöz öksürük; %4,9 hastamıza psikojenik öksürük; %2,2 Gastroözefagial reflü hastalığı; %1,1 hastaya broşiektazi; %1,1 hastaya Primer silier diskinezi; %0,55 hastaya eosinophilic esophagitis tanısı konuldu. Tartışma: Çocukluk çağında Kronik öksürüğe altta yatan birçok farklı hastalık sebep olabilmektedir. Hastalara sıklıkla antibiyotik, semptom giderici gibi ilaçların gereksiz yere kullanıldığı gözlenmektedir. Hastaların doğru şekilde değerlendirilmesi, özellikle öykünün detaylı alınması bu olguların yönetiminde oldukça önemlidir. Her hastanın kendi özgülünde değerlendirilmesi oldukça kıymetlidir.

Anahtar Kelimeler

• astım
• çocukluk çağı
• etyolojik değerlendirme
• kronik öksürük

Kaynakça

1. 1. Ioan J, Poussel M, Coutier L, et al. What is chronic cough in children? Front Physiol. 2014; 5: 322. https://doi.org/10.3389/fphys.2014.00322
2. 2. Bergamini M, Kantar A, Cutrera R, Italian Pediat¬ric Cough Group.Analysis of the Literature on Chronic Cough in Children. Open Respir Med J. 2017 Apr 27;11:1-9. https://doi.org/10.2174/1874306401711010001
3. 3. Morise AH, Fontana GA, Sovijarvi ARA, et al. The diagnosis and manage¬ment of chronic cough. Eur Respir J.2004;24:481-92. https://doi.org/10.1183/09031936.04.00027804
4. 4. Chang AB, Glomb WB. Guidelines for evaluating chronic cough in paediatrics: ACCP Evidence-base clinical practice guideline. Chest. 2006;129 (1); 260-83. https://doi.org/10.1378/chest.129.1_suppl.260S
5. 5. Shields M D, Bush A, Everard M L, et al. Recom-mendations for the assessment and management of cough in children. Thorax. 2008;63 (Suppl III): ii1-iii15. https://doi.org/10.1136/thx.2007.077370
6. 6. Martin J, Townshend J, Brodlie M. Diagnosis and management of asthma in children. BMJ Paediatr Open. 2022 Apr;6(1):e001277. https://doi.org/10.1136/bmjpo-2021-001277
7. 7. Ying-Xia L, Qing-Long G, Jun D, et al. Upper air-way cough syndrome in children and two inflam-matory factors: TRPV1 and TGF-β2. Int J Pediatr Otorhinolaryngol. 2014 Mar;78(3):445-50. https://doi.org/10.1016/j.ijporl.2013.12.010
8. 8. Chang AB, Upham JW, Masters JB, et al. Pro-tracted bacterial bronchitis: The last decade and the road ahead. Pediatr Pulmonol. 2016 Mar;51(3):225-42. https://doi.org/10.1002/ppul.23351 9. Braman SSJC. Postinfectious cough: ACCP evi-dence-based clinical practice guidelines. Chest. 2006;129(1):138S-46S. https://doi.org/10.1378/chest.129.1_suppl.138S

9. 10. Qusay H, Fares A, Magdoleen F, et al. Manage-ment and diagnosis of psychogenic cough, habit cough, and tic cough: a systematic review. Chest. 2014 Aug;146(2):355-72. https://doi.org/10.1378/chest.14-0795
10. 11. Ullmann N, Mirra V, Di Marco A, et al. Asthma: Differential Diagnosis and Comorbidities. Front Pediatr. 2018 Oct 3;6:276. https://doi.org/10.3389/fped.2018.00276
11. 12. Chang AB, Bush A, Grimwood K. Bronchiectasis in children: diagnosis and treatment. Lancet. 2018 Sep 8;392(10150):866-79. https://doi.org/10.1016/S0140-6736(18)31554-X
12. 13. Behan L, Dimitrov BD, Kuehni CE, et al. PICA-DAR: a diagnostic predictive tool for primary cili-ary dyskinesia. European Respiratory Journal 2016 47: 1103-12. https://doi.org/10.1183/13993003.01551-2015
13. 14. Gonsalves NP, Aceves SS. Diagnosis and treat-ment of eosinophilic esophagitis. J Allergy Clin Immunol. 2020 Jan;145(1):1-7. https://doi.org/10.1016/j.jaci.2019.11.011
14. 15. Rehman N, Morais-Almeida M, Wu AC. Asthma Across Childhood: Improving Adherence to Asthma Management from Early Childhood to Ad¬olescence. J Allergy Clin Immunol Pract. 2020 Jun;8(6):1802-7. https://doi.org/10.1016/j.jaip.2020.02.011
15. 16. Qiao Y-N, Lin S-Z, Duan X-Z, et al. A random-ized, double-blind, placebo-controlled multicenter clinical trial of Xiehuang Jiejing granule in the treatment of cough variant asthma in children. Medicine (Baltimore) 2022 18;101(46):e31636. https://doi.org/10.1097/MD.0000000000031636
16. 17. Bousquet J, Khaltaev N, Cruz AA, et al; World Health Organization; GA(2)LEN; Allergen. Aller-gic Rhinitisandits impact on Asthma (ARIA) 2008 update. Allergy. 2008;63 Suppl 86:8-160. 18. Fan Gao, Qing-Long Gu, Zi-Dong Jiang. Upper airway cough syndrome in 103 children. Chin Med J (Engl). 2019 Mar 20;132(6):653-658. https://doi.org/10.1097/CM9.0000000000000118
17. 19. Kompare M, Weinberger M. Protracted bacterial bronchitis in young children: association with air-way malacia. J Pediatr 2012; 160:88-92. https://doi.org/10.1016/j.jpeds.2011.06.049
18. 20. Goyal V, Grimwood K, Marchant JM, et al. Does failed chronic wet cough response to antibiotics predict bronchiectasis? Arch Dis Child 2014;99:522-525. https://doi.org/10.1136/archdischild-2013-304793
19. 21. J T Grayston. Chlamydia pneumoniae (TWAR) infections in children. Pediatr Infect Dis J. 1994 Aug;13(8):675-84 https://doi.org/10.1097/00006454-199408000-00001
20. 22. Snyder J, Fisher D. Pertussis in childhood. Pediatr Rev. 2012 Sep;33(9):412-20 https://doi.org/10.1542/pir.33.9.412
21. 23. Irwin RS, Glomb WB, Chang AB. Habit cough, tic cough, and psychogenic cough in adult and pediat¬ric populations: ACCP evidence-based clinical practice guidelines. Chest 2006 Jan;129(1 Suppl):174S-179S. https://doi.org/10.1378/chest.129.1_suppl.174S
22. 24. Khoshoo V, Mohnot S, Haydel JrR, et al. Bron-chial hyperreactivity in non-atopic children with asthma and reflux: effect of anti-reflux treatment. Pediatr Pulmonol. 2009 Nov;44(11):1070-4. https://doi.org/10.1002/ppul.21094
23. 25. Chang AB, Connor FL, Petsky HL, et al. An ob-jective study of acid reflux and cough in children using an ambulatory pHmetry-cough logger. Arch. Dis. Child. (2011). 96, 468-72. https://doi.org/10.1136/adc.2009.177733