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Q: I have a 10 year old daughter who has a chronic cough but no wheezing and I was told by her physician that she has asthma. I have read somewhere, however, that wheezing must usually be present in order to diagnose asthma. Hence, I am confused as to how can my daughter have asthma if she does not have any wheezing?
A: The diagnosis of asthma is usually based on the repetitive nature of the presenting symptoms, the identification of specific triggers that may cause an asthma attack, family history of the disease, and the response to appropiate therapy. You are right in that wheezing is, in fact, the presenting physical sign most commonly associated with asthma. However, it does occur rather frequently, particularly in children, that asthma presents with chronic cough rather than wheezing. Just as in the case of your daughter, a child presenting with a history of chronic cough when breathing deeply or when laughing is, in fact, a very common presentation of asthma.
Updated: 03/07/99
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