Cough Variant Asthma as a Phenotype of Classic Asthma

Cough variant asthma (CVA) was first described by Glauser. CVA was described as the isolated chronic cough as the only presenting symptom responsive to bronchodilator therapy. The authors now suggest that CVA is present with airway hyperresponsiveness, eosinophilic inflammation of central and peripheral airways and bronchodilator responsive coughing without typical manifestation of asthma such as wheezing or dyspnea. Pathologically, CVA shares common features such as eosinophilic inflammation and remodeling changes with classic asthma. Because of that, CVA is clinically considered as a variant type of asthma, a phase at the beginning of asthma pathogenesis or as a precursor of classic asthma. Nearly 30% of patients with CVA eventually develop intermittent wheezing, an average of 3–5 years. It is clinically very important to recognize CVA because long-term inhaled corticosteroids can significantly decrease the development of classic asthma in these patients.