AL Wright, CJ Holberg, WJ Morgan, LM Taussig, M Halonen and FD Martinez
Department of Pediatrics and Respiratory Sciences Center, College of Medicine, University of Arizona, Tucson, USA.

Risk factors for recurrent cough (RC) in childhood, and its relation to asthma were investigated as part of the prospective, longitudinal Tucson Children's Respiratory Study. RC, defined as > or = 2 episodes of cough without a cold in the past year, was assessed by questionnaire in 987 children at age 6. Children having RC without wheeze (n = 154) did not differ from children with neither symptom (n = 610) in serum IgE levels, skin test response, size-corrected forced expiratory flow, or percentage of decline following cold air challenge. In contrast, children with both RC and wheeze (n = 116) had significantly more respiratory illness, more atopy, lower flow at end-tidal expiration (V'maxFRC), and greater declines in lung function following cold air challenge than children with neither symptom. Current parental smoking was a risk for RC without wheeze, whereas male gender, maternal allergy, wheezing lower respiratory tract illness (LRI) in early life, and high IgE were significant risks for RC with wheeze, compared with children having neither symptom. RC early in life resolved in the majority of children, between ages 2-3 yr and age 6, and between age 6 and age 11. High IgE and positive skin prick test were associated with persistence of RC to age 6 among children who wheezed, and markers of allergy were associated with persistence of RC between 6 and 11 yr. These findings suggest that recurrent cough in the absence of wheeze differs in important respects from classic asthma, and using the same label to refer to these distinct syndromes may obscure their diverse pathophysiologies.

This article has been cited by other articles:

				D. Keeley Cough in children: new guidelines from the British Thoracic Society Postgrad. Med. J., September 1, 2008; 84(995): 449 - 449. [Full Text] [PDF]

				K M Eastham, D M Hammal, L Parker, and D A Spencer A follow-up study of children hospitalised with community-acquired pneumonia Arch. Dis. Child., September 1, 2008; 93(9): 755 - 759. [Abstract] [Full Text] [PDF]

				M D Shields, A Bush, M L Everard, S McKenzie, R Primhak, and on behalf of the British Thoracic Society Cough Gu Recommendations for the assessment and management of cough in children Thorax, April 1, 2008; 63(Suppl_3): iii1 - iii15. [Full Text] [PDF]

				N. Beydon, S. D. Davis, E. Lombardi, J. L. Allen, H. G. M. Arets, P. Aurora, H. Bisgaard, G. M. Davis, F. M. Ducharme, H. Eigen, et al. An Official American Thoracic Society/European Respiratory Society Statement: Pulmonary Function Testing in Preschool Children Am. J. Respir. Crit. Care Med., June 15, 2007; 175(12): 1304 - 1345. [Full Text] [PDF]

				A. Gupta, M. McKean, and A. B Chang Management of chronic non-specific cough in childhood: an evidence-based review Arch. Dis. Child. Ed. Pract., April 1, 2007; 92(2): 33 - 39. [Full Text] [PDF]

				M. B Anthracopoulos, E. Liolios, D. B Panagiotakos, K. Triantou, and K. N Priftis Prevalence of asthma among schoolchildren in Patras, Greece: four questionnaire surveys during 1978-2003 Arch. Dis. Child., March 1, 2007; 92(3): 209 - 212. [Abstract] [Full Text] [PDF]

				A. B. Chang and W. B. Glomb Guidelines for Evaluating Chronic Cough in Pediatrics: ACCP Evidence-Based Clinical Practice Guidelines Chest, January 1, 2006; 129(1_suppl): 260S - 283S. [Abstract] [Full Text] [PDF]

				H. Mochizuki, H. Arakawa, K. Tokuyama, and A. Morikawa Bronchial Sensitivity and Bronchial Reactivity in Children With Cough Variant Asthma Chest, October 1, 2005; 128(4): 2427 - 2434. [Abstract] [Full Text] [PDF]

				C. Hermann, T. Westergaard, B. V. Pedersen, J. Wohlfahrt, A. Host, and M. Melbye A Comparison of Risk Factors for Wheeze and Recurrent Cough in Preschool Children Am. J. Epidemiol., August 15, 2005; 162(4): 345 - 350. [Abstract] [Full Text] [PDF]

				A.H. Morice and committee members The diagnosis and management of chronic cough Eur. Respir. J., September 1, 2004; 24(3): 481 - 492. [Full Text] [PDF]

				J C de Jongste and M D Shields Cough * 2: Chronic cough in children Thorax, November 1, 2003; 58(11): 998 - 1003. [Abstract] [Full Text] [PDF]

				S A McKenzie and A Bush Difficult asthma in children Arch. Dis. Child., February 1, 2003; 88(2): 168 - 169. [Abstract] [Full Text] [PDF]

				S A McKenzie and A Bush Difficult asthma in children Thorax, October 1, 2002; 57(10): 915 - 916. [Abstract] [Full Text] [PDF]

				J V West Acute upper airway infections: Childhood respiratory infections Br. Med. Bull., March 1, 2002; 61(1): 215 - 230. [Abstract] [Full Text] [PDF]

				S.A. McKenzie, M. Mylonopoulou, and P.D. Bridge Bronchodilator responsiveness and atopy in 5-10-yr-old coughers Eur. Respir. J., December 1, 2001; 18(6): 977 - 981. [Abstract] [Full Text] [PDF]

				P. G. GIBSON, J. L. SIMPSON, A. C. CHALMERS, R. C. TONEGUZZI, P. A. B. WARK, A. J. WILSON, and M. J. HENSLEY Airway Eosinophilia Is Associated with Wheeze But Is Uncommon in Children with Persistent Cough and Frequent Chest Colds Am. J. Respir. Crit. Care Med., September 15, 2001; 164(6): 977 - 981. [Abstract] [Full Text] [PDF]

				M J Davies, P Fuller, A Picciotto, and S A McKenzie Persistent nocturnal cough: randomised controlled trial of high dose inhaled corticosteroid Arch. Dis. Child., July 1, 1999; 81(1): 38 - 44. [Abstract] [Full Text]

				H. LEWIS Chronic cough: is it asthma? Arch. Dis. Child., June 1, 1999; 80(6): 579h - 579. [Full Text]

				A. B CHANG    Isolated cough: probably not asthma Arch. Dis. Child., March 1, 1999; 80(3): 211 - 213. [Full Text]

				A O Faniran, J K Peat, and A J Woolcock Persistent cough: is it asthma? Arch. Dis. Child., November 1, 1998; 79(5): 411 - 414. [Abstract] [Full Text]

				A. B Chang, P. D Phelan, J. B Carlin, S. M Sawyer, and C. F Robertson A randomised, placebo controlled trial of inhaled salbutamol and beclomethasone for recurrent cough Arch. Dis. Child., July 1, 1998; 79(1): 6 - 11. [Abstract] [Full Text]

				A. B Chang, P. D Phelan, S. M Sawyer, S. Del Brocco, and C. F Robertson Cough sensitivity in children with asthma, recurrent cough, and cystic fibrosis Arch. Dis. Child., October 1, 1997; 77(4): 331 - 334. [Abstract] [Full Text]

				K. L. TIMONEN, J. NIELSEN, J. SCHWARTZ, A. GOTTI, V. VONDRA, C. GRATZIOU, P. G. AeVER, W. ROEMER, and B. BRUNEKREEF Chronic Respiratory Symptoms, Skin Test Results, and Lung Function as Predictors of Peak Flow Variability Am. J. Respir. Crit. Care Med., September 1, 1997; 156(3): 776 - 782. [Abstract] [Full Text] [PDF]

				M. Silverman, N. Wilson;, and N. SPEIGHT Asthma---time for a change of name? • Commentary Arch. Dis. Child., July 1, 1997; 77(1): 62 - 65. [Full Text]