Cough variant asthma.

Cough variant asthma (CVA), a phenotype of asthma solely presenting with coughing, is the most common cause of chronic cough in Japan, which lasts for 8 weeks or longer. It shares some clinical and pathophysiological features with classic asthma with wheezing such as seasonal or nocturnal coughing, airway hyperresponsiveness, eosinophilic airway inflammation and airway remodeling. The key diagnostic feature of CVA is the responsiveness of coughing to bronchodilators (beta-agonists), but the mainstay treatment after the established diagnosis is the long-term treatment with inhaled corticosteroids with or without other controller antiasthma medica- tions. Progression of CVA to classic asthma could be prevented with an early introduction of inhaled corticosteroids. Treatment of concomitant gastroesophageal reflux disease, which/ often coexists with CVA, may be considered in intractable cases.