Sunday, December 14, 2008

Is It a Cough or Asthma - Both - Cough Varient Asthma

I love to watch that show Mystery Diagnosis on the Discovery Health Channel. I don't like the show because I am all that interested in medicine, or science, I like the show because it reinforces an idea that I initially had a lot of trouble with - Doctors frequently have no idea what they are talking about. I think I grew up believing Doctors were authority figures who always knew about which they spoke, and should not be questioned. Many years later after an unfortunate foray into allergies and asthma, I discovered this was not true.

Since Conor has a cold, and we are again fighting the asthma, I thought I would share some info on the type of asthma he has - Cough Variant Asthma. Many doctors failed to diagnose what was wrong with him, and we had many claim it was simply yet another bout of bronchitis, croup, or just a really nasty cough. Even after having the diagnosis, I have had pediatricians, and ER doctors not believe me. (Pediatrician said just a bad cough. Ended up in the ER later that day because of terrible strider and trouble breathing - ER doc was convinced it HAD to be croup. Very cool allergist confirmed not croup, but asthma at follow up appointment.)

So, here is some general information on Cough Variant Asthma.

"Cough-variant asthma is a clinical syndrome seen in children with persistent cough, absence of wheezing on examination, and reversible obstructive changes in lung function. The cough-variant phenotype is seen in approximately 25% of children with asthma, and it can be difficult to recognize and treat.

Children with cough-variant asthma are often symptomatic for a long period before an accurate diagnosis is made and can be misdiagnosed as having recurrent bronchitis or even psychogenic cough. Such children often receive multiple rounds of antibiotics before being referred to a specialist. Lung function testing is required to make an accurate diagnosis but can also be normal."

Pediatric Planet
"What is it?
Some children with a persistent cough have a condition called "cough variant asthma." This means that we believe that the child is coughing because his or her breathing tubes (bronchi) are reacting to irritation by squeezing in to a smaller size, just like in asthma. Children with cough variant asthma do not make the wheezing sound that we usually hear in children with ordinary asthma, though. This can make it difficult to diagnose the condition, and very often children with cough variant asthma have been through a number of other diagnoses or treatments. Parents of children with cough variant asthma usually find that regular cough and cold medicines don’t help their children, and of course antibiotics don’t help either. Cough variant asthma can be a very frustrating condition.
Once of the most important clues to learning that a child has cough variant asthma is that these children very often get a cough with every cold or upper respiratory infection (URI). The cough usually lasts for much longer than the original infection. Like children with regular asthma, children with cough variant asthma usually have other "triggers" that can set off a cough. These triggers can be things in the environment like smoke, dust, pollen, animal hair and dander, dust mites, roaches or many other things. Often weather changes can also be triggers. Children with cough variant asthma often cough more at night, which can be very disruptive for the child and the family."

A few more online resources.

Web MD

And anytime you are annoyed at your Doctor, be sure to check out Mystery Diagnosis

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