Cough Variant Asthma

Cough is a major symptom of asthma. However, "cough variant asthma" (CVA) defines a different group of asthmatics rather than asthmatics who cough. CVA has higher sensitivity in cough reflex and have lower threshold for cough response to bronchoconstriction. Pathological findings in CVA are not different from classical asthmatics. Physical examination and pulmonary functions can totally be normal. Resolution of cough with bronchodilators, differentiate CVA from other causes of cough and is an important feature in diagnosis. Bronchoprovocation test with inhaled methacholine should be used to document the presence of bronchial hyperresponsiveness and therefore the diagnosis of asthma. Treatment principals of CVA are the same as in classical asthma. Bronchodilators are usually enough for intermitant cough, while persistant symptoms require inhaler corticosteroids. Step- up therapy should be considered in CVA in whom inhaled steroids are not enough.