Prevalence and associated factors of airway hyper- responsiveness in children with recurrent chronic cough
Keywords:
airway hyper-responsiveness, recurrent chronic cough, histamine provocation test, prick test, atopy, passive smoking, cough variant asthma
Abstract
Background Airway hyper-responsiveness (AH) is a common char-acteristic of asthma. Patient who has recurrent chronic cough with
AH is commonly referred as “cough variant asthmaâ€. Histamine
provocation test should be performed to determine whether a pa-
tient has “cough variant asthma†or recurrent viral bronchitis.
Objective To determine AH prevalence in children with recurrent
chronic cough and factors associated with it.
Methods A cross sectional study was conducted on 6-12 year-old
children with recurrent chronic cough at the Pediatrics Outpatient
Clinic, Sanglah Hospital Denpasar from September 2002 until June
2003
Results Twenty one out of 64 (33%) subjects suffering from recur-
rent chronic cough without wheezing had AH. Associated factors
significantly associated with AH were age, allergic rhinitis, pater-
nal and maternal history of atopy, passive smoking, use of mos-
quito-coil, positive skin prick test, and eosinophilia. Spearman cor-
relation analysis between associated factors and AH showed that
positive skin prick test and passive smoking were moderately cor-
related with AH (r=0.56, p<0.0001; r=0.57, p<0.0001, respectively),
whereas multivariate regression logistic analysis on associated
factors found true associated factors, such as positive skin prick
test (p=0.01; OR=14.82), history of atopy in father (p=0.02;
OR=22.75), and passive smoking (p=0.03; OR=11.97).
Conclusions The prevalence of airway hyper-responsiveness in
children with recurrent chronic cough without history of wheezing
was 33%. Independent associated factors of AH in recurrent chronic
cough children are positive skin prick test, history of atopy in fa-
ther, and passive smoking
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airway hyper-responsiveness, and asthma. Arch Dis
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25. Frischer T, Kuehr J, Meinert R, Karmaus W, Barth R,
Hermann-Kunz E, et al. Maternal smoking in early child-
hood: a risk factor for bronchial responsiveness to exercise
in primary-school children. J Pediatr 1992;121:17-22.
26. Forastiere F, Agabiti N, Corbo GM, Pistelli R, Dell’Orco
V, Ciappi G, et al. Passive smoking as a determinant of
bronchial responsiveness in children. Am J Respir Crit
Care Med 1994;149:365-70.
27. Backer V, Ulrik CS, Hansen KK Laursen EM, Dirksen A, Bach-
Mortensen N. Allergy and bronchial reactivity in children and
adolescents from Copenhagen. Ugeskr Laeger 1993;155:3982-6.
28. Postma DS, Bleecker ER, Amelung PJ, Holroyd KJ, Xu J,
Panhuysen CIM, et al. Genetic susceptibility to asthma –
bronchial hyper-responsiveness coinherited with a major
gene for atopy. N Engl J Med 1995;333:894-900.
29. Munasir Z. Uji provokasi bronkial. In: Akib AAP,
Matondang CS. Buku ajar alergi-imunologi anak.
Jakarta: BP IDAI; 1996. p. 317-9.
30. Annema JT, Sparrow D, O’Connor GT, Rijcken B,
Koeter GH, Postma DS, et al. Chronic respiratory symp-
tom and airway responsiveness to methacholine are
associated with eosinophilia in older men: the norma-
tive aging study. Eur Respir J 1995;8:62-9.
31. Sont JK, Booms P, Bel EH, Vandenbroucke JP, Sterk
PJ. The determinants of airway hyper-responsiveness
to hypertonic saline in atopic asthma in vivo: Relation-
ship with sub-populations of peripheral blood leucocytes.
Clin Exp Allergy 1993;23:678-88.
32. Weller PF. Human eosinophils. J Allergy Clin Immunol
1997;100:283-7.
atau berulang pada anak: tinjauan khusus pengaruh
sinusitis. In: Rahajoe N, Rahajoe NN, Budiman I, edi-
tors. Perkembangan dan masalah pulmonologi anak
saat ini. Jakarta: FKUI; 1994. p. 129-42.
2. Van Asperen PP. Chronic and recurrent cough in chil-
dren: an Australian experience. In: Rahajoe N,
Rahajoe NN, Budiman I, editors. Perkembangan dan
masalah pulmonologi anak saat ini. Jakarta: FKUI;
1994. p. 103-27.
3. Faniran AO, Peat JK, Woolcock AJ. Persistent cough:
is it asthma? Arch Dis Child 1998;79:411-4.
4. Neijens HJ. Bronchial hyperreactivity. In: Tjokronegoro
A, Cornain S, Widowati R, editors. Allergy and immunol-
ogy in Asian-Pacific region. Jakarta: Perhimpunan Alergi
dan Imunologi Indonesia; 1989. p. 3-4.
5. Cockroft DW, Hargreave FE. Airway hyper-responsive-
ness: definition, measurement, and clinical relevance.
In: Kaliner MA, Barnes PJ, Persson CGA, editors.
Asthma: its pathology and treatment. New York: Marcel
Dekker Inc; 1991. p. 51-72.
6. Bratawidjaja K. Hiperreaktivitas saluran napas. Maj
Kedokt Indones 1989;39:111-5.
7. Van Asperen PP. Atopy, bronchial hyper-responsive-
ness and inflammation in childhood asthma. In:
Rahajoe N, Rahajoe NN, Budiman I, editors.
Perkembangan dan masalah pulmonologi anak saat ini.
Jakarta: FKUI; 1994. p. 183- 91.
8. Jansen DF, Schouten JP, Vonk JM, Rijcken 0B, Timens
W, Kraan J, et al. Smoking and airway hyper-responsive-
ness especially in the presence of blood eosinophilia,
increase the risk to develop respiratory symptoms: a
25-year follow-up study in general adult population.
Am J Respir Crit Care Med 1999;160:259-64.
9. Peat JK, Salome CM, Woolcock AJ. Factors associated
with bronchial hyper-responsiveness in Australian
adults and children. Eur Respir J 1992;5:921-9.
10. Backer V, Bach-Mortensen N, Dirksen A. Prevalence
and predictors of bronchial hyper-responsiveness in
children aged 7-16 years. Allergy 1989;44:214-9.
11. Weitzman M, Gortmaker S, Walker DK, Sobol A.
Maternal smoking and childhood asthma. Pediatrics
1990;85:505-11.
12. Ulrik CS. Bronchial responsiveness to inhaled histamine
in both adults with intrinsic and extrinsic asthma: the
importance of prechallenge forced expiratory volume in
1 second. J Allergy Clin Immunol 1993;91:120-6.
13. Bryant DH, Boscato LM, Mboloi PN, Stuart MC. Al-
lergy to laboratory animals among animal handlers.
Med J Aust 1995;163: 415-8.
14. Ulrik CS. Factors associated with increased bronchial re-
sponsiveness in adolescents and young adult: The impor-
tance of adjustment for prechallange FEV 1 . J Allergy Clin
Immunol 1996;97:761-7.
15. Budiman I. Peranan dan penanggulangan inflamasi
sebagai upaya pencegahan dan tatalaksana asma pada
anak. In: Rahajoe N, Rahajoe NN, Budiman I, editors.
Perkembangan dan masalah pulmonologi anak saat ini.
Jakarta: FKUI; 1994. p.193-200.
16. Sheffer AL. Definition and diagnosis of asthma. J Allergy
Clin Immunol 1991;88:425-35.
17. Sovijarvi AR, Malmberg LP, Reinikainen K, Rytila P, Poppius
H. A rapid dosimetric method with controlled tidal breath-
ing for histamine challenge. Repeatability and distribution
of bronchial reactivity in a clinical material. Chest
1993;104:164-70.
18. Cockcroft DW, Killian DN, Mellon JJA, Hargreave FE.
Bronchial reactivity to inhaled histamine: a method and
clinical survey. Clin Allergy 1977;7:235-43.
19. Sparrow D, O ’ Connor GT, Rosner B, Segal MR, Weiss ST.
The influence of age and level of pulmonary function on
non specific airway responsiveness: the normative aging
study. Am Rev Respir Dis 1991;143:978-82.
20. Sears MR, Holdaway MD, Flannery EM, Herbison GP,
Silva PA. Parental and neonatal risk factors for atopy,
airway hyper-responsiveness, and asthma. Arch Dis
Child 1996;75:392-8.
21. Reed CE, Townley RG. Asthma classification and
pathogenesis. In: Middleton E, Reed CE, Eclis EF, edi-
tors. Allergy principles and practice, Vol. 2. Saint Louis:
Mosby; 1978. p. 659-73.
22. Rosalina I, Kartasasmita CB, Soepriadi M. Prevalence
and risk factors of asthma in children aged 13-14 years.
Pediatr Indones 1998;38:265-72.
23. Barnes PJ, Lundberg JM. Airways neuropeptides and
asthma. In: Asthma: its pathology and treatment. Kaliner
MA, Barnes PJ, Persson CGA, ED. New York: Marcel
Dekker inc; 1991. p. 394.
24. Martinez FD, Antognoni G, Macri F, Bonci E, Midulla F,
De Castro G, et al. Parental smoking enhances bronchial
responsiveness nine-year-old children. Am Rev Respir Dis
1988;138:518-23.
25. Frischer T, Kuehr J, Meinert R, Karmaus W, Barth R,
Hermann-Kunz E, et al. Maternal smoking in early child-
hood: a risk factor for bronchial responsiveness to exercise
in primary-school children. J Pediatr 1992;121:17-22.
26. Forastiere F, Agabiti N, Corbo GM, Pistelli R, Dell’Orco
V, Ciappi G, et al. Passive smoking as a determinant of
bronchial responsiveness in children. Am J Respir Crit
Care Med 1994;149:365-70.
27. Backer V, Ulrik CS, Hansen KK Laursen EM, Dirksen A, Bach-
Mortensen N. Allergy and bronchial reactivity in children and
adolescents from Copenhagen. Ugeskr Laeger 1993;155:3982-6.
28. Postma DS, Bleecker ER, Amelung PJ, Holroyd KJ, Xu J,
Panhuysen CIM, et al. Genetic susceptibility to asthma –
bronchial hyper-responsiveness coinherited with a major
gene for atopy. N Engl J Med 1995;333:894-900.
29. Munasir Z. Uji provokasi bronkial. In: Akib AAP,
Matondang CS. Buku ajar alergi-imunologi anak.
Jakarta: BP IDAI; 1996. p. 317-9.
30. Annema JT, Sparrow D, O’Connor GT, Rijcken B,
Koeter GH, Postma DS, et al. Chronic respiratory symp-
tom and airway responsiveness to methacholine are
associated with eosinophilia in older men: the norma-
tive aging study. Eur Respir J 1995;8:62-9.
31. Sont JK, Booms P, Bel EH, Vandenbroucke JP, Sterk
PJ. The determinants of airway hyper-responsiveness
to hypertonic saline in atopic asthma in vivo: Relation-
ship with sub-populations of peripheral blood leucocytes.
Clin Exp Allergy 1993;23:678-88.
32. Weller PF. Human eosinophils. J Allergy Clin Immunol
1997;100:283-7.
Published
2016-10-10
How to Cite
1.
Adnyana IGAN, Suwendra P, Santoso H. Prevalence and associated factors of airway hyper- responsiveness in children with recurrent chronic cough. PI [Internet]. 10Oct.2016 [cited 23Apr.2024];44(5):181-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/760
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Received 2016-10-02
Accepted 2016-10-02
Published 2016-10-10
Accepted 2016-10-02
Published 2016-10-10
