Respiratory Disorders Community
Chronic cough 3 years and going
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Chronic cough 3 years and going

My daughter is 8 and has had a chronic cough since the end of 2009. She has a daily cough where she coughs almost constantly some days and then has a few days when she doesn't cough hardly at all that day and then about 12 times a year has a horrible worsened cough that sounds like the croup or bronchitis. We are under the care of a large childrens hospital in our home state but I am not happy with the care she is receiving. We still don't have a diagnosis or any treatment. Her testing shows:

-peribronchial thickening bilaterally on chest xray and CT scan and bilateral hilar adenopathy on chest xray
-moderate clubbing of fingers
-crackling in left lower lobe
-evidence of pansinusitis on sinus xray
-EOS% high, RDW Value low, MONOS% high, complete RAST high on everything but shrimp and pork, CH50 normal, ANA normal, ANCA and P-ANCA normal, Tetanus AB and Diptheria AB normal, IgM Low from 2 different blood studies, IgG and IgA low on one but normal on the second
-Sweat Chloride screening borderline at 60, 46 mutation panel negative, waiting on gene sequencing
-Alpha-1 testing: carrier MZ

I sent her records to Childrens Hospital in Houston, TX. They looked them  over and wrote a letter stating that they believe she should be seen by National Jewish because they have a team combined of pulmonology, immunology, and psychology (she has medical procedure phobia) and they aren't sure whether her issues stem from a pulmonological or immunological standpoint. I called the lung line and was told that they don't usually see children especially with special needs such as that and we should go to a childrens hospital. Her pulmonary function studies are always normal and her pulse-oximetry is always good. There have been so cardiac studies done other than chest xray. We need answers, please.
3 Comments Post a Comment
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Avatar_dr_f_tn
Hello and hope you are doing well.

As her pulmonary function tests are normal, check to see if the cough is due to other causes like a post nasal drip. Repeated episodes of dry cough, runny nose and throat irritation could most probably be due to allergens. These are substances like pollen, dust, animal dander, certain foods, insect venoms and certain medications. Exposure to allergens causes a runny nose with a resultant post nasal drip where secretions from the nose go backward into the throat and irritate causing cough. Cough is a protective mechanism by the body as it helps to prevent infections. You could consult an allergy specialist. In the meantime for relief from her symptoms she could do warm salt gargles and staem inhalations.

Hope this helped and do keep us posted.
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Avatar_f_tn
She is allergic to a lot of things. We already knew this. Her pulmonologist believes she may have chronic bronchitis of unknown cause. He wants her to be worked up by immunology and gastroenterology before further looking into this though. Chronic bronchitis makes sense except I don't know why as she was never exposed to smoke or large amounts of dust or anything of that nature. In fact, she has an expensive air purifier in her room. Thank you for responding. I still worry about possible heart or sarcoidosis. She gets heart pains, sharp that last a few seconds to ten minutes sometimes. The pulmonologist says he's not worried about her heart cause it looked normal on chest xray and ct scan of her lungs but I would feel better with an ECHO to completely rule it out.
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Avatar_dr_f_tn
Hello and hope you are doing well.

Understand your predicament. Another possibility is tuberculosis. Infections like tuberculosis can cause an evening rise of temperature and increased sweating. This also causes a loss of appetite; as such this is accompanied by weight loss. So, record her temperatures, on a two hourly basis to detect an evening rise of temperature.  Please check with your doctor to rule out this condition.

Hope this helped and do keep us posted.
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