Successful resolution of refractory chronic cough induced by gastroesophageal reflux with treatment of baclofen 英文参考文献.docVIP

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Successful resolution of refractory chronic cough induced by gastroesophageal reflux with treatment of baclofen 英文参考文献.doc

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Successful resolution of refractory chronic cough induced by gastroesophageal reflux with treatment of baclofen 英文参考文献

Xuetal.Cough2012,8:8 /content/8/1/8 Cough CASE REPORT OpenAccess Successfulresolutionofrefractorychroniccough inducedbygastroesophagealrefluxwith treatmentofbaclofen XianghuaiXu,QiangChen,SiweiLiang,HanjingLüandZhongminQiu* Abstract Gastroesophagealrefluxinducedcoughisacommoncauseofchroniccough,andprotonpumpinhibitorsarea standardtherapy.However,thepatientsunresponsivetothestandardtherapyaredifficulttotreatandremaina challengetodoctors.Here,wesummarizedtheexperienceofsuccessfulresolutionofrefractorychroniccoughdue togastroesophagealrefluxwithbaclofeninthreepatients.Itisconcludedthatbaclofenmaybeaviableoptionfor gastroesophagealrefluxinducedcoughunresponsivetoprotonpumpinhibitortherapy. Keywords:Baclofen,Chroniccough,Gastroesophagealreflux,Multi-channelintraluminalimpedancecombinedwith pHmonitoring Introduction radiographs and lung function, negative bronchial Gastroesophageal reflux induced cough (GERC) is a provocation to methacholine, positive IgE specific to common cause of chronic cough and accounts for 5- dustmiteandsoybeanintheserum,1.5%ofeosinophils 41%ofchroniccough.[1]Althoughprotonpumpinhibi- in induced sputum, normal findings in fiberobroncho- torsarea standard therapyforGERC,somepatientsdo scope, and only submucosal edema with infiltration of not respond totheantireflux medical treatment andre- scattered eosinophils and lymphocytes into airway mu- main a challenge to doctors. Here, we report three cosa as described by the pathologist examining the bi- patientswithGERCresistant toprotonpumpinhibitors opsy examples. A further 24-hour esophageal pH butsuccessfullytreatedwithbaclofen. monitoring revealed an abnormal acid-reflux with a DeMeester score of 61.4 and the symptom association probability of 99%. Then, the presumptive diagnosis of GERCwasestablishedandoralomeprazole20mgtwice a day was commenced. Three months later, his heart- burnandacidregurgitationdisappearedwhilethecough did not improve. The patient’s cough persisted de