Abstract

Background: Coughing is one of the chronic respiratory symptoms of patients exposed to sulfur mustard (SM) used against Iranian combatants and civilians by Iraq during the Iran-Iraq war, between 1983 and 1989. This study carried out on SM exposed patients who referred to our clinic because of exacerbation of chronic cough. Method: Fifty male SM injured patient in the age range of 21-79 years, all of them having chronic bronchitis and were suffering from chronic cough (> 3 weeks) were evaluated. After history taking and performing physical examination our diagnostic evaluation included chest X-ray, pulmonary function test (PFT), para nasal computerized tomography, esophageal endoscopy and fiber optic bronchoscopy. Results: Apart from having chronic bronchitis as a constant disease in all patients, the other main causative factors behind chronic cough were bronchospasm, post-nasal drip syndrome (PNDS), and gastro esophageal reflux disease (GERD), which accounted for 66, 46 and 44 of chronic cough of the patients, respectively. A single cause for chronic cough was found in 4 patients (8), 2 causes in 17 patients (34) 3 causes in 23 patients (46) and 4 causes in 6 patients (12). Conclusion: Since a high majority of the patients had more than a single cause for chronic cough, multiplicity of causes of chronic cough in a patient is indicative for evaluation of possible exposure to chemical fumes, especially SM. Because of high prevalence of chronic bronchitis (100) and bronchospasm (66) among our study group we conclude that they should be considered at first, before assessment of other causes. (c) 2004 Elsevier B.V. All rights reserved.