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The Etiologic Diseases and Diagnostic Usefulness of Color Doppler Ultrasonography in Children with Chronic Coughs

Journal of the Korean Pediatric Society 2002;45(4):489-497.
Published online April 15, 2002.
The Etiologic Diseases and Diagnostic Usefulness of Color Doppler Ultrasonography in Children with Chronic Coughs
Sun Young Park, Joon Sung Lee
Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
소아 만성 기침의 원인 질환과 컬러 도플러 초음파검사의 진단적 유용성
박선영, 이준성
가톨릭대학교 의과대학 소아과학교실
Correspondence: 
Joon Sung Lee, Email: jslee@cmc.cuk.ac.kr
Abstract
Purpose
: The objectives of this study were to investigate the causes of chronic cough and to establish the appropriate diagnostic approach to chronic cough in children.
Methods
: One hundred and thirty two cases of chronic cough were prospectively evaluated. They visitors to pediatric chronic cough clinics at Kang-nam saint Mary's Hospital of Catholic University from August 2000 to July 2001 for 12 months. Careful history taking by questionnaire, physical examination, radiologic studies of chest and sinus, hematologic and immunologic studies, allergic skin tests, and methacholine challenge tests were performed. Color doppler(CD) ultrasonography were performed and compared with simultaneous 24 Hr. esophageal pH monitoring to diagnose gastroesophageal reflux disease(GERD).
Results
: Age distributions were demonstrated that nine in infants, 82 in early childhood, 38 in late childhood, and three in adolescence. Common causes of chronic cough were bronchial asthma in 40 cases, chronic sinusitis in 22 cases, GERD in seven cases, bronchial asthma combined with sinusitis in 28 cases, bronchial asthma combined with GERD in 14 cases, psychogenic cough in two. cases, foreign body in one case, chronic bronchitis in one case, and bronchiolitis in one case. Comparing with 24 Hr. pH monitoring, sensitivity, specificity, positive predictive value and negative predictive values of CD ultrasonography were 88%, 69%, 85 %, and 73% respectively.
Conclusion
: The most common causes of chronic cough in children were bronchial asthma, sinusitis and GERD in order. We suggest that CD ultrasonography can be used as a good, convenient screening method for patients with suspected GERD in outpatient settings.
Key Words: Chronic cough, Bronchial asthma, Sinusitis, Gastroesophageal reflux disease(GERD), Color doppler(CD) ultrasonography


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