Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:3.4.15.1 (ACE)
 18,300 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chronic cough is defined as persistence of the symptom for longer than one month. It is a common reason for consultation. A systematic diagnostic approach based on the history, clinical examination and a number of investigations (chest x-ray, lung function tests, oesophageal pH monitoring and sinus x-rays) reveals the cause in most cases. The main aetiologies are post-nasal drip, gastro-oesophageal reflex, asthma, chronic bronchitis, and the use of angiotensin converting enzyme inhibitors. Nevertheless, in some cases, the cause is not found. In this situation it is necessary to search for less common pathologies where cough is just a symptom of systemic disease, such as connective tissue disorder (Sjogren's syndrome, atrophic polychondritis), vasculitis (Wegener's granulomatosis), Horton's syndrome (cluster headaches), amyloidosis and inflammatory bowel disease. It may also be a matter of local pathology of the tracheo-bronchial tree, such as tracheo-bronchomegaly, tracheopathia osteoplastica, rare or unrecognized infections (whooping cough, post-viral cough, bronchial tuberculosis), reactive bronchial dysfunction, eosinophilic bronchitis or radiologically occult bronchial carcinoma. Il is also necessary to consider vocal cord dysfunction and cough due to medication before accepting a diagnosis of psychogenic cough.
 ...
PMID:[Unrecognized causes of chronic cough]. 1204 Mar 21

Chronic cough is a common problem in patients who visit physicians. The three most common causes of persistence cough in nonsmokers who were not taking an ACE inhibitor and who had a normal or stable chest radiograph are: postnasal drip, asthma and gastroesophageal reflux. After a viral upper respiratory infection, it takes sometimes seven weeks for bronchial airway hyperreactivity to return to normal. By using a standard protocol, 95 percent of patients with chronic cough can be managed successfully but in some cases it may take even five months or more to determine a diagnosis and effective treatment.
 ...
PMID:[Chronic cough--etiological diagnosis problems]. 1475 33

Postnasal drip, asthma and gastroesophageal reflux disease are the underlying causes in almost 90% of cases with chronic cough. Causal treatment is successful in the majority of patients, although in the event of a long-standing cough, it might need to be continued over several weeks. Smoking complicates the identification of cough as a clinical early symptom of an underlying tumor. Cardiac causes are rare, and in most cases are due to the use of ACE-inhibitors. Cough may be triggered by a variety of causes and the therapeutic palette must include several spectra. Since the individual causes often cannot be unequivocally identified, it may be necessary to take a polypragmatic therapeutic approach targeting the three most common causes simultaneously for 7-10 days.
 ...
PMID:[Differential diagnosis and treatment of chronic cough]. 1553 30

A cough is defined as chronic, if it exceeds 8 weeks in length. Post-nasal drip (PND), bronchial asthma and gastro-esophageal reflux (GERD) must be systematically investigated, as these account for 90 percent of chronic cough cases. In addition to medical history and examination which should exclude either a postinfectious cough or coughing related to ACE inhibitor medication, a new evaluation model suggests chest X ray and spirometry as the initial step. A chronic cough is rarely due to one cause as in at least 25% of cases 2 etiologies are present. An effective treatment of chronic cough often relies on several medication trials until its disappearance. After a multidisciplinary approach to chronic cough using this investigative model, the diagnosis of idiopathic or psychogenic cough should remain exceptional.
 ...
PMID:[Chronic cough: practical aspects]. 1734 50

Cough is a common presenting symptom of many patients managed by allergists. For patients with chronic cough who are nonsmokers, have normal spirometry, and are not being treated with an ACE inhibitor, diagnosis usually focuses on differentiation between postnasal drip syndrome, asthma, gastroesophageal reflux disease, and nonasthmatic eosinophilic bronchitis, alone or in combination. Patients with severe COPD or GERD should be referred to appropriate specialists for those conditions. The management of conditions commonly treated by allergists (e.g., allergic rhinitis, asthma, sinusitis) follows the recommendations of current guidelines and/or practice parameters.
 ...
PMID:Chronic cough: the allergist's perspective. 1795 6

The most common causes of chronic cough in nonsmokers are postnasal drip syndrome, asthma, and gastroesophageal reflux disease. Drugs are also important in the etiology of resistant cough. Most common drugs inducing cough are the ACE inhibitors. Many drugs other than ACE inhibitors can also cause dry cough and one among them is topiramate. It is a new generation, efficacy-proved antiepileptic drug that is used widely for migraine prophylaxis in many countries. Most common adverse events of topiramate are paresthesia, cognitive symptoms, fatigue, insomnia, nausea, loss of apetite, anxiety, and dizziness. There is only one case report about topiramate associated cough in the literature. The present report refers to a patient, presenting with cough who is on topiramate treatment for migraine prophylaxis.
 ...
PMID:As a rare cause of drug-induced cough: topiramate. 2242 60

Chronic cough has been reported to be the fifth most common complaint seen by primary care physicians in the world, the third in Italy. Chronic cough in non-smoking, non-treated with ACE-inhibitor adults with normal chest radiogram could be a symptom of asthma and can be sub-classified into: cough-variant asthma, atopic cough, and eosinophilic bronchitis. This review discusses the differential diagnosis of these three disorders.
 ...
PMID:Cough variant asthma and atopic cough. 2295 94

Chronic cough is a frustrating and common problem, resulting in significant psychological and physical sequelae as well as enormous financial costs in terms of health care expense and time lost from work. Decreased QoL and depression are common. However, using a systematic approach, including assessing whether the patient uses ACE-I and cigarettes, excluding the presence of red flags and risk factors for life-threatening diseases, and obtaining and normal chest radiograph, more than 90% of cases of chronic cough are diagnosed as being caused by UACS, asthma, or GERD. It is recommended to address these conditions sequentially, starting with UACS. Nonasthmatic eosinophilic bronchitis and pertussis infections are unrecognized by primary care providers and should be considered after UACS, asthma, and GERD have been addressed. Finally, cough hypersensitivity syndrome is a new area of research and has been hypothesized to be the underlying factor in many cases of chronic cough, regardless of the inciting factor. More clinical research is needed to further elucidate the cough reflex pathway and the factors involved in modulating its sensitivity, which may eventually lead to new antitussive therapeutics.
 ...
PMID:Evaluation and treatment of chronic cough. 2475 53

Cough is one of the most common symptom of many respiratory diseases. The Korean Academy of Tuberculosis and Respiratory Diseases organized cough guideline committee and cough guideline was developed by this committee. The purpose of this guideline is to help clinicians to diagnose correctly and treat efficiently patients with cough. In this article, we have stated recommendation and summary of Korean cough guideline. We also provided algorithm for acute, subacute, and chronic cough. For chronic cough, upper airway cough syndrome (UACS), cough variant asthma (CVA), and gastroesophageal reflux disease (GERD) should be considered. If UACS is suspicious, first generation anti-histamine and nasal decongestant can be used empirically. In CVA, inhaled corticosteroid is recommended in order to improve cough. In GERD, proton pump inhibitor is recommended in order to improve cough. Chronic bronchitis, bronchiectasis, bronchiolitis, lung cancer, aspiration, angiotensin converting enzyme inhibitor, habit, psychogenic cough, interstitial lung disease, environmental and occupational factor, tuberculosis, obstructive sleep apnea, peritoneal dialysis, and idiopathic cough can be also considered as cause of chronic cough. Level of evidence for treatment is mostly low. Thus, in this guideline, many recommendations are based on expert opinion. Further study regarding treatment for cough is mandatory.
...
PMID:The Korean Cough Guideline: Recommendation and Summary Statement. 2677 Feb 30

Cutaneous sarcoidosis is not an uncommon disorder, and the skin can be the sole manifestation in about 10% of patients. However, when the involved anatomical area of the cutaneous sarcoidosis is the scalp and it presents as a scarring alopecia, there is an increased risk of a systemic disease (1,2). A 79-year-old Caucasian male patient presented to our Institute with annular and painless plaques of the scalp, with variable diameter, showing a reddish and yellowish color (Figure 1, a). Furthermore, a scleroderma-like atrophy of the skin with an exposure of the underlying vasculature was present (Figure 1, b). The patient reported that these lesions began to appear 2 years ago, with a worsening in the last 6 months. He also reported a chronic cough and dyspnea. According to the patient's medical history, he was treated for tinea capitis with radiotherapy of the scalp at the age of 7, with temporary hair-loss and subsequent total re-growth. Additionally, during the last 7 years he was diagnosed with mental depression and treated accordingly. The histology revealed typical epithelioid cell granulomas without central necrosis in association with a sparse lymphocytic infiltrate. Elastosis with ectatic vessels, sclerosis, and edema was also present in the upper dermis (Figure 1, c, d) A diagnosis of cutaneous sarcoidosis of the scalp was established. Laboratory investigations, including hepatitis B and C viral serology, anti-nuclear antibodies, antibodies to extractable nuclear antigen, cardiolipin, beta2 glycoprotein immunoglobulin G antibodies, and lymphoid subsets were all in normal ranges, whereas the angiotensin converting enzyme level was 124 (range: 65-114) IU/L. The chest radiography showed diffuse interstitial nodulations with bilateral and right para-tracheal lymphadenopathies, and the histology revealed pulmonary sarcoidosis (Figure 2). As of this writing, the patient is undergoing steroidal treatment with periodical clinical and instrumental follow-up, with poor response from the cutaneous lesions but an improvement of the pulmonary symptoms. Scalp sarcoidosis is a not frequent finding (1). Most of the reported cases are Afro-American female patients. Although the main clinico-pathological differential diagnosis is atypical necrobiosis lipoidica, this entity differs from cutaneous sarcoidosis by an absence of scalp scarring alopecia and by the fact that the annular lesions are often limited to the face, without involving the scalp (1-4). Additionally, histologically atypical necrobiosis lipoidica does not reach the typical features of a sarcoid granuloma. Other potential misdiagnoses are morphea, discoid lupus erythematosus, and lichen plano-pilaris (1-4). Sarcoidosis is most likely driven by a putative antigen in genetically susceptible individuals (5). Although radiation exposure is one of the possible causes of sarcoidosis, the radiotherapy used for the fungal infection did not have any role in the onset of the disease in our patient, as confirmed by the normal total regrowth of the hairs and the long-time interval. Regarding the therapy (mainly steroids, azathioprine, and hydroxychloroquine), if compared to other anatomical sites, the grade of atrophy in the scalp is always too high to allow an objective clinical response, as observed in our patient. This case emphasizes that in cutaneous annular sarcoidosis of the scalp, an underlying systemic sarcoidosis is often present.
 ...
PMID:Atrophic and Annular Scarring Alopecia of the Scalp as a Finding in Underlying Systemic Sarcoidosis. 3006 4


<< Previous 1 2 3 Next >>