Productive cough, a forgotten phenotype of refractory chronic cough.

Asthma Bronchiectasis Cough Sputum

Journal

Respiratory medicine and research
ISSN: 2590-0412
Titre abrégé: Respir Med Res
Pays: France
ID NLM: 101746324

Informations de publication

Date de publication:
15 Apr 2024
Historique:
received: 08 02 2024
revised: 09 04 2024
accepted: 10 04 2024
medline: 7 6 2024
pubmed: 7 6 2024
entrez: 6 6 2024
Statut: aheadofprint

Résumé

Refractory chronic cough (RCC) patients typically complain of a dry cough. Sputum production in these patients has rarely been described in the literature. However, sputum production in RCC may be common, troublesome and particularly challenging to manage. We aimed to characterise patients referred to our regional specialist cough clinic who have significant sputum production (≥1 teaspoon of sputum daily) and compare their demographics, symptomatology and investigation results to those presenting with a dry RCC. A retrospective case note analysis of all consecutive referrals to a tertiary cough clinic identified as having a productive cough (≥1 teaspoon of sputum daily) was performed over a 12-month period. They were compared to a paired number of patients with dry RCC. Patients with productive cough represented nearly a quarter (98/398, 24.6 %) of new patient referrals to the clinic. Demographic information, symptomatology and investigation results were comparable to those with a dry RCC. Over a third, 35.8 % of patients with a productive cough reported expectorating an egg-cupful of sputum or more a day. Nearly half, 40% of those with high volume sputum production (≥egg-cupful daily) had both a normal CT thorax and normal spirometry. Patients with RCC can expectorate significant volumes of sputum in the absence of underlying lung disease. This group have similar demographics to those with dry RCC. This is the first piece of work to our knowledge to describe this cohort. Future work needs to acknowledge this forgotten phenotype to ensure that they receive comprehensive evaluation and evidenced based treatment.

Sections du résumé

BACKGROUND BACKGROUND
Refractory chronic cough (RCC) patients typically complain of a dry cough. Sputum production in these patients has rarely been described in the literature. However, sputum production in RCC may be common, troublesome and particularly challenging to manage.
AIMS OBJECTIVE
We aimed to characterise patients referred to our regional specialist cough clinic who have significant sputum production (≥1 teaspoon of sputum daily) and compare their demographics, symptomatology and investigation results to those presenting with a dry RCC.
METHODS METHODS
A retrospective case note analysis of all consecutive referrals to a tertiary cough clinic identified as having a productive cough (≥1 teaspoon of sputum daily) was performed over a 12-month period. They were compared to a paired number of patients with dry RCC.
RESULTS RESULTS
Patients with productive cough represented nearly a quarter (98/398, 24.6 %) of new patient referrals to the clinic. Demographic information, symptomatology and investigation results were comparable to those with a dry RCC. Over a third, 35.8 % of patients with a productive cough reported expectorating an egg-cupful of sputum or more a day. Nearly half, 40% of those with high volume sputum production (≥egg-cupful daily) had both a normal CT thorax and normal spirometry.
CONCLUSIONS CONCLUSIONS
Patients with RCC can expectorate significant volumes of sputum in the absence of underlying lung disease. This group have similar demographics to those with dry RCC. This is the first piece of work to our knowledge to describe this cohort. Future work needs to acknowledge this forgotten phenotype to ensure that they receive comprehensive evaluation and evidenced based treatment.

Identifiants

pubmed: 38843596
pii: S2590-0412(24)00022-9
doi: 10.1016/j.resmer.2024.101106
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

101106

Informations de copyright

Crown Copyright © 2024. Published by Elsevier Masson SAS. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Jenny King (J)

University of Manchester, Division of Infection, Immunity and Respiratory Medicine, and Manchester Academic Health Science Centre, Manchester, UK; North West Lung Centre, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Southmoor Road, Manchester. M239LT, UK. Electronic address: jenny.king@manchester.ac.uk.

James Wingfield Digby (JW)

University of Manchester, Division of Infection, Immunity and Respiratory Medicine, and Manchester Academic Health Science Centre, Manchester, UK; North West Lung Centre, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Southmoor Road, Manchester. M239LT, UK.

Sarah Hennessey (S)

North West Lung Centre, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Southmoor Road, Manchester. M239LT, UK.

Paul Marsden (P)

University of Manchester, Division of Infection, Immunity and Respiratory Medicine, and Manchester Academic Health Science Centre, Manchester, UK; North West Lung Centre, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Southmoor Road, Manchester. M239LT, UK.

Jaclyn Smith (J)

University of Manchester, Division of Infection, Immunity and Respiratory Medicine, and Manchester Academic Health Science Centre, Manchester, UK; North West Lung Centre, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Southmoor Road, Manchester. M239LT, UK.

Classifications MeSH