Asthma is one of the most common aetiologies of chronic cough. In a subgroup of asthmatics, cough may be the predominant or sole symptom. This condition is referred to as cough variant asthma (CVA). The diagnosis of CVA often presents a challenge since physical examination and spirometric tests may be normal. Up to 50% of patients with CVA have associated eosinophilic bronchitis, with the degree of eosinophilia being similar to that of other asthmatics. Demonstration of bronchial hyperresponsiveness by methacholine inhalation challenge, elevated level of exhaled nitric oxide and sputum eosinophilia support the presence of CVA, but the diagnosis is confirmed only upon resolution of the cough with specific antiinflammatory treatment.
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