Uncommon causes of chronic cough in non-smoking adults

Introduction: upper airway cough syndrome (UACS), asthma and gastroesophageal reflux (GER) account for the majority of causes of chronic cough (CC) in non-smoking adults. However, less frequent cough causes are also diagnosed. Objective: the aim of the study was to analyze less common reasons of cough which were diagnosed in non-smoking adults admitted to our department due to CC. Patients and Methods: the study was a retrospective analysis of patients with CC diagnosed between 2016 and 2018. Results: 151 adults were diagnosed due to CC [(111F, 40M; median age 56 years (IQR 41-66); median cough duration 48 months (IQR 24-120)] in the analyzed period. A single CC cause was found in 40 patients, ≥ 2 causes were identified in the remaining group. Asthma, UACS and GER were diagnosed in 63, 89 and 83 adults, respectively. Less common CC causes were diagnosed in 47 patients (31%). These included: swallowing disorders (n=8, in 5 patients due to neurological diseases), obstructive sleep apnea (n=7), non-asthmatic eosinophilic bronchitis (n=5), arrhythmia (n=5), cough due to treatment with ACE inhibitors (n=3), hiatal hernia (n=4), bronchiectasis (n=3), chronic bronchitis (n=2), laryngeal diseases (n=2), somatic cough (n=3). In single patients, pulmonary metastases (breast carcinoma), Ig-G4 disease, sarcoidosis, non-tuberculous mycobacterium infection and posttraumatic hernia of the diaphragm. Conclusions: CC causes other than asthma, UACS and GER are not rare in non-smoking adults and should be considered in the differential diagnosis of CC.