Cough-Predominant Laryngeal Hypersensitivity Syndrome in a Middle-Aged Woman: A Case Report

TL;DR

A middle-aged woman with a persistent dry cough was diagnosed with laryngeal hypersensitivity syndrome after normal tests ruled out other causes.

Contribution

This case highlights laryngeal hypersensitivity syndrome as a potential cause of chronic cough when standard tests are normal.

Findings

The patient had a persistent dry cough with no identifiable cause from standard investigations.

Flexible bronchoscopy revealed marked laryngeal hypersensitivity as the underlying issue.

Management included education, hydration, and behavioral strategies to suppress coughing.

Abstract

A middle-aged woman presented with a three-month history of sudden-onset persistent dry cough, with no preceding respiratory illness or significant medical history. She was an active smoker with a prior heavy smoking history. Initial investigations, including chest imaging, computed tomography of the neck and thorax, pulmonary function testing, and otolaryngological assessment, were normal. Speech and language therapy evaluation did not reveal any abnormalities of breathing or voice function.

Flexible bronchoscopy demonstrated normal lower airway anatomy but revealed marked laryngeal hypersensitivity, with minimal contact provoking repetitive coughing. In the absence of an alternative pathology, a diagnosis of cough-predominant laryngeal hypersensitivity syndrome was made. Management focused on patient education, hydration, behavioral cough suppression strategies, and measures to reduce laryngeal irritation. This case underscores the importance of considering laryngeal hypersensitivity syndrome in patients with unexplained chronic cough despite normal routine investigations.

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