II. Epidemiology

  1. Emerging cause of Chronic Cough in pulmonology clinics
  2. Responsible for 10-30% of Chronic Cough cases referred to pulmonology

III. Differential Diagnosis

IV. Diagnosis

  1. Normal airway hyper-responsiveness (i.e. not Asthma)
    1. Normal Spirometry
    2. Normal airway responsiveness on Methacholine inhalation test
  2. Sputum Eosinophilia (i.e. not Chronic Bronchitis)
    1. Induced Sputum (via saline nebulization) with 3% or more Eosinophils
  3. No signs variable airflow obstruction

V. Management

  1. Does not respond to Inhaled Bronchodilators
  2. Eliminate Occupational Lung Disease and inhaled allergan exposures
  3. High-dose Inhaled Corticosteroids
  4. Brief initial course of Systemic Corticosteroids may be considered if Inhaled Corticosteroids ineffective

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