Department of Respiratory Medicine, Kyoto University, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan; Department of Respiratory Medicine, The Tazuke Kofukai Medical Research Institute Kitano Hospital, 2-4-20 Ohgimachi, Kita-ku, Osaka, Japan; Department of Internal Medicine, Japan Baptist Hospital, 47 Yamanomoto-cho, Kitashirakawa, Sakyo-ku, Kyoto, 606-8273, Japan
A 15-year-old girl was referred with a 2-year history of perennial non-productive cough, which had been preceded by Mycoplasma pneumoniae pneumonia and subsequent asthma. Symptoms were only partially responsive to anti-asthma treatment including an inhaled corticosteroid and a leukotriene receptor antagonist. The patient's BMI was 27.8; she had gained over 10 kg in the previous two years. Typical symptoms of gastroesophageal reflux disease were not evident except for belch. Coughing worsened on eating and rising from bed. Although esophagography failed to disclose reflux esophagitis, esophageal pH monitoring revealed significant acid reflux. Asthma was considered well controlled. Treatment with the proton-pump inhibitor rabeprazole resulted in disappearance of cough. Frequency Scale for the Symptoms of Gastroesophageal reflux disease (FSSG) score, a questionnaire evaluating the symptoms of gastroesophageal reflux disease, was initially high but normalized after treatment. Capsaicin cough sensitivity also diminished with treatment. Chronic cough due to gastroesophageal reflux disease has been considered rare in adolescents, but this condition might be increasing in line with the recent trend in adults. Clinical features of gastroesophageal reflux disease-associated cough typical for adult patients and a specific questionnaire for evaluating gastroesophageal reflux disease validated in adults may also be useful diagnostic clues in adolescents.
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(1) Irwin R, Curley F, French C: Chronic cough. The spectrum and frequency of causes, key components of the diagnostic evaluation, and outcome of specific therapy. Am Rev Respir Dis 1990, 141:640-647.
(2) Fujimura M, Abo M, Ogawa H, Nishi K, Kibe Y, Hirose T, Nakatsumi Y, Iwasa K: Importance of atopic cough, cough variant asthma and sinobronchial syndrome as causes of chronic cough in the Hokuriku area of Japan. Respirology 2005, 10:201-207.
(3) Niimi A: Geography and cough aetiology. Pulm Pharmacol Ther 2007, 20:383-387.
(4) Matsumoto H, Niimi A, Takemura M, Ueda T, Yamaguchi M, Matsuoka H, Jinnai M, Chin K, Mishima M: Prevalence and clinical manifestations of gastro-oesophageal reflux-associated chronic cough in the Japanese population. Cough 2007, 3:1.
(5) Niimi A, Ueda T, Chung K, Mishima M: Geographic difference in chronic cough etiology: comparison between Japan and the UK. Am J Respir Crit Care Med 2007, 175(abstract issue):A380 (abstract).
(6) Irwin R: Chronic cough due to gastroesophageal reflux disease: ACCP evidence-based clinical practice guidelines. Chest 2006, 129:80S-94S.
(7) Holinger L: Chronic cough in infants and children. Laryngoscope 1986, 96:316-322.
(8) Chang A: Cough: are children really different to adults? Cough 2005, 1:7.
(9) The Japanese respiratory society guidelines for management of cough Respirology 2006, 11(Suppl 4):S135-186.
(10) Everett C, Morice A: Clinical history in gastroesophageal cough. Respir Med 2007, 101:345-348.
(11) Kusano M, Shimoyama Y, Sugimoto S, Kawamura O, Maeda M, Minashi K, Kuribayashi S, Higuchi T, Zai H, Ino K, et al.: Development and evaluation of FSSG: frequency scale for the symptoms of GERD. J Gastroenterol 2004, 39:888-891.
(12) Gibson P, Fujimura M, Niimi A: Eosinophilic bronchitis: clinical manifestations and implications for treatment. Thorax 2002, 57:178-182.
(13) Niimi A, Matsumoto H, Ueda T, Takemura M, Suzuki K, Tanaka E, Chin K, Mishima M, Amitani R: Impaired cough reflex in patients with recurrent pneumonia. Thorax 2003, 58:152-153.
(14) Ohhama Y, Suzuki N: Working group of Japanese society for pediatric alimentary motility; Guidelines for pediatric 24-h esophageal pH monitoring. Jpn J Pediatr Surg 1997, 29.
(15) Johnson L, Demeester T: Twenty-four-hour pH monitoring of the distal esophagus. A quantitative measure of gastroesophageal reflux. Am J Gastroenterol 1974, 62:325-332.
(16) Chang A, Widdicombe J: Cough throughout life: children, adults and the senile. Pulm Pharmacol Ther 2007, 20:371-382.
(17) Marchant J, Masters I, Taylor S, Cox N, Seymour G, Chang A: Evaluation and outcome of young children with chronic cough. Chest 2006, 129:1132-1141.
(18) Holinger L, Sanders A: Chronic cough in infants and children: an update. Laryngoscope 1991, 101:596-605.
(19) Hart J: Pediatric gastroesophageal reflux. Am Fam Physician 1996, 54:2463-2472.
(20) Shepherd R, Wren J, Evans S, Lander M, Ong T: Gastroesophageal reflux in children. Clinical profile, course and outcome with active therapy in 126 cases. Clin Pediatr (Phila) 1987, 26:55-60.
(21) Vandenplas Y, Lifshitz J, Orenstein S, Lifschitz C, Shepherd R, Casaubón P, Muinos W, Fagundes-Neto U, Garcia Aranda J, Gentles M, et al.: Nutritional management of regurgitation in infants. J Am Coll Nutr 1998, 17:308-316.
(22) Mochizuki H, Morikawa A: Nanchisei-gaisou-no- rinshou-to-chiryohou. Asthma Frontier 2003, 2:66-75.
(23) Vakil N, van Zanten S, Kahrilas P, Dent J, Jones R: The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol 2006, 101:1900-1920. quiz 1943
(24) Eastburn M, Katelaris P, Chang A: Defining the relationship between gastroesophageal reflux and cough: probabilities, possibilities and limitations. Cough 2007, 3:4.
(25) Jacobson B, Somers S, Fuchs C, Kelly C, Camargo CJ: Body-mass index and symptoms of gastroesophageal reflux in women. N Engl J Med 2006, 354:2340-2348.
(26) Marchant J, Masters I, Taylor S, Chang A: Utility of signs and symptoms of chronic cough in predicting specific cause in children. Thorax 2006, 61:694-698.
(27) Laukka M, Cameron A, Schei A: Gastroesophageal reflux and chronic cough: which comes first? J Clin Gastroenterol 1994, 19:100-104.
(28) Ing A: Cough and gastro-oesophageal reflux disease. Pulm Pharmacol Ther 2004, 17:403-413.
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