Chronic Cough as the Sole Presenting Manifestation of Bronchial Asthma

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Abstract
Six patients with chronic cough, without history of dyspnea or wheezing, had normal base-line spirometry but hyper-reactive airways, as demonstrated with methacholine. Maintenance therapy with bronchodilators promptly eliminated the cough in all patients. Three to 12 months later therapy was discontinued for three days, cough returned, and detailed pulmonary-function studies were carried out. Again, base-line values were normal, but after methacholine one-second forced expiratory volume decreased an average of 40 per cent in the patients as compared to 3 per cent in normal controls (P2 per liter, as compared to 1.4 in normal controls (P<0.01). Specific airway conductance was lowered in patients and controls, but the post-methacholine value was significantly lower in the patients.