Chest
Clinical Investigations: Misc-Ellaneous: ArticlesChronic Cough with a History of Excessive Sputum Production: The Spectrum and Frequency of Causes, Key Components of the Diagnostic Evaluation, and Outcome of Specific Therapy
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Materials and Methods
From February 23, 1988 to March 2, 1992, 97 consecutive and unselected, immunocompetent patients with CCS defined as cough with production of greater than 30 mL of sputum per day for at least 3 weeks, were seen by one of us (R.S.I.) in our pulmonary outpatient clinic. Of these, 26 failed to return for follow-up and were eliminated from analysis. The remaining 71 patients made up our study group. Seventy-three percent were referred by another physician; 27% were self-referred. The entrance
Spectrum and Frequency of the Causes of Chronic Cough With a History of Excessive Sputum Production
Our study group consisted of 39 men and 32 women with an average age of 58±17 years (range, 18 to 86 years). They had complained of cough productive of more than 30 mL of phlegm per day for an average of 69±95 months (range, 1 to 480 months). Using posttreatment diagnostic criteria, the cause of CCS was determined in 69 of 71 (97%) patients. The only patients who failed to respond to treatment adequately were (1) a woman who met pretreatment diagnostic criteria for PNDS and GERD, had an initial
Discussion
Human respiratory mucus is a mixture composed of approximately 95% water, 1% protein, 0.9% carbohydrate, and 0.8% lipid.1 The constituents of mucus are produced by a variety of cells in the lining of the respiratory tract, including goblet cells, submucosal gland cells, plasma cells, Clara cells, and alveolar type II pneumocytes. The normal volume of mucus produced by the lower respiratory tract in humans has been estimated to range from 10 to 100 mL/d.1 Mucus is also produced in the upper
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Presented in part at the Annual Meeting of the American Thoracic Society, San Francisco, May 1993 (abstract published in Am Rev Respir Dis 1993; 147:A871).