Ask The Expert
December 23, 2021
Constant Itchy Throat with Cough
I have a case to present. A woman who is 62 years old complained of constant itchy throat for many years. She tried many kinds of antihistamine drugs without good effect. I can't find any environmental factors influencing her disease. She has been to Australia without a change in symptoms. The SPT showed negative results. I prescribed 1st generation and 2nd generation antihistamines for her without good effect. I can't explain it. She does not have asthma nor allergic rhinitis, etc. She coughs sometimes because of the itching.
From the Editors: Allergists around the world are often presented with “constant itchy throat and cough” as a problem. Our two experts provide answers to this common scenario which allow each of us to brush up on an educated and formal approach to resolving it.
From Dr Mandel Sher, Editor: In this case of chronic, unresponsive throat itch and cough, it suggests a non-anatomic etiology (however LPR is still a possiblility) with neurogenic hyper-responsiveness that is commonly seen in chronic idiopathic/refractory/recalcitrant cough. In this case, trials of amitryptylline or gabapentin should be considered.
By Dr. Iris E. Hidalgo Nicho
If cough as a result of itchy throat is the only symptom for years, we are facing a case of chronic cough. Cough in adults is defined as chronic when it lasts for more than 8 weeks. Chronic cough is present in 5-10% of the adult population, mainly in women older than 50 years, who present a hyper-reactive response to a trigger causing a strong sensation of throat tickling/irritation that urges them to cough.
By Prof Giovanni Passalacqua
The causes of itchy throat with cough (especially if long-lasting) are multiple. I suppose that asthma has been properly excluded by means of spirometry, nonspecific bronchial challenge (methacholine) or bronchodilation, and angiotensin converting inhibitors are not taken.
By Dr. Desiree Larenas-Linnemann and Dr. Gary Stadtmauer
Reviewing, we have a 62 year-old patient with a chronic complaint of an itchy throat and some cough that does not seem to improve with a change in environment nor with anti-histamines.
There are a few key elements and questions to think about regarding this patient's history. The first is the patient's age which suggests that the problem may not be atopy.
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