Interpreting the histopathology of chronic cough: a prospective, controlled, comparative study
UMass Chan Affiliations
Department of PathologyDepartment of Medicine, Division of Pulmonary, Allergy, and Critical Care
Information Services, Academic Computing Services
Department of Cell Biology
Document Type
Journal ArticlePublication Date
2006-08-11Keywords
AsthmaBronchi
Bronchitis
Bronchoscopy
Chronic Disease
Coin Lesion, Pulmonary
Cough
Cross-Sectional Studies
Diagnosis, Differential
Female
Humans
Lung Neoplasms
Male
Middle Aged
Prognosis
Prospective Studies
Severity of Illness Index
Smoking
Allergy and Immunology
Critical Care
Respiratory Tract Diseases
Metadata
Show full item recordAbstract
HYPOTHESIS: Trauma from chronic coughing produces airway inflammation similar to diseases causing cough. DESIGN: Prospective, cross-sectional, controlled, clinicopathologic correlation study in four groups: group 1, cough from intrapulmonary diseases; group 2, cough from extrapulmonary diseases; group 3, cough that was unexplained; and group 4, nonsmoking, asymptomatic control subjects. METHODS: Patients with chronic cough underwent a standardized workup including endobronchial biopsies before treatment. Causes were determined by a favorable response to therapy. Bronchial biopsy samples from control subjects were obtained from surgical specimens. RESULTS: There were 24 adult subjects (13 women and 11 men) with mean cough duration of 8.6 +/- 7.4 years (+/- SD). Thirteen patients had cough due to a specific disease: intrapulmonary diseases in 5 patients, and extrapulmonary diseases in 8 patients. Eleven patients had unexplained cough. Compared to control subjects, there was minimal-to-moderate chronic inflammation in all coughers (p < or = 0.0004), in group 1 (p < or = 0.039), group 2 (p = 0.061), and group 3 (p < or = 0.025) diseases that were not correlated with cough duration. There was no difference in type of inflammation, cough duration, or smoking history between groups, nor were there histologic differences between subjects with explained causes of cough compared with unexplained cough. CONCLUSIONS: Our findings suggest that airway inflammation associated with chronic cough, assessed on morphologic appearance and inflammatory cell counting in hematoxylin-eosin-prepared samples, may be due to the trauma of coughing, and the inflammation may be similar to that seen with diseases putatively thought to cause chronic cough. Investigators must be cautious when attributing pathogenic importance to observed inflammatory changes in airways of coughing subjects.Source
Chest. 2006 Aug;130(2):362-70. Link to article on publisher's siteDOI
10.1378/chest.130.2.362Permanent Link to this Item
http://hdl.handle.net/20.500.14038/35272PubMed ID
16899833Related Resources
Link to article in PubMedae974a485f413a2113503eed53cd6c53
10.1378/chest.130.2.362