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I have had a cough for over 6 mths did a bronchial scope…

I have had a...

I have had a cough for over 6 mths did a bronchial scope which showed to many white blood cells in my lungs. I have been on prednisone for 2 weeks 30mg and showing no help. Any ideas

Doctor's Assistant: When were you prescribed prednisone? How severe were any side effects?

I have been taking it since feb 26. Hot flashes is only side effects

Doctor's Assistant: Have you seen a doctor about hot flashes?

I talked to him and ignored it

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

I had middle lobe removed for lung cancer 10 years ago

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Answered in 1 minute by:
3/13/2018
Dr. Arun Phophalia
Category: Medical
Satisfied Customers: 37,785
Experience: MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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Welcome to Just Answer.
Answers here are for education and information.
I will respond shortly with an answer, or further information request.

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What is your age?

Was a biopsy done via bronchoscopy which showed the white blood cells in the lung tissue?

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Customer reply replied 1 month ago
47%
Customer reply replied 1 month ago
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I saw the report.

There is an high number of eosinophils. This denote allergic disorder.

Prednisone may take further longer duration to show the improvement.

Meanwhile you should consult an allergy specialist and allergy tests would be recommended.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

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Customer reply replied 1 month ago
I took allergy test and showed nothing

Your doctor can add the following medications;

1) Anti allergic.

2) Montelukast which is mast cell stabilizer.

The diagnostic and management protocol for the chronic cough is as following;

1) we will do a chest x-ray first; which sure may have been done for you and would be normal.

2) pulmonary function tests or spirometry is the second step

3) starting of empiric therapy for postnasal drip, asthma, or gastroesophageal reflux. The GERD can be sometimes uncontrolled despite the medications and this will need further evaluation in the form of esophageal manometry (food pipe pressure study) and pH study of the food pipe (esophagus).

4) methacholine challenge testing to evaluate for airway hyperreactivity; done for the bronchospasm / bronchial asthma.

5) sputum or phlegm examination for eosinophils or empiric trial of corticosteroids for eosinophilic bronchitis which is your likely diagnosis.

If despite these measures, cough persists we would consider further investigations like esophagoscopy, 24-hour pH probe monitoring, high-resolution chest CT.

The other common causes of chronic cough are postnasal drip (also called upper airway cough syndrome), asthma, and gastroesophageal reflux disease (GERD). These three causes are responsible for up to 90 percent of all cases of chronic cough. Less common causes include infections, medications, and chronic lung diseases. Another common cause of chronic cough is nonasthmatic eosinophilic bronchitis.

It is privilege assisting you.

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Customer reply replied 1 month ago
Thank you. I have tried all those

You are very welcome.

Did your upper GI endoscopy and 24 hours pH estimation of esophagus show any abnormality?

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What did your high resolution CT scan of lung show?

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Customer reply replied 1 month ago
Ct just showed scarring but everything normal

And upper GI endoscopy and lung function tests?

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Customer reply replied 1 month ago
Normal

So best course is to persist with prednisone, which should show resolution by next week.

Was this information helpful to you? I would be glad to answer any further questions.

Best wishes,

It was my pleasure to help you.

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Customer reply replied 1 month ago
Thank you

You are most welcome.

Wishing you a speedy resolution.

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Was this information helpful to you? I would be glad to answer any further questions.

It is privilege assisting you.

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Dr. Arun Phophalia
Category: Medical
Satisfied Customers: 37,785
Experience: MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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