Hi Jermom,

Cough variant asthma (CVA) is a tough diagnosis in kids. It's most frequent feature is a chronic cough, in the absense of the other typical asthma symptoms (chest tightness, wheezing, shortness of breath). You don't say how they tested him, but it is typical for kids to with CVA to have normal pulmonary function tests.Usually, a methocholine challenge test is needed to find the microscopic changes that occur with CVA.

The American College of Chest Physicians found that addition of Zafirkulast, a leukotriene modifier, may help with treating CVA that has not responded adequately to steroids and a bronchodilator.

Zafirkulast appears to suppress a cough that has been inadequately treated with inhaled steroids. Experts believe that Zafirkulast inhibits inflammation in the airway cough receptors, making them less sensitive. It is unclear if leukotrienes could be used alone as first-line therapy. So, you might ask your son's physician about the possibility of trying that.

At any rate, if you're not satisfied with your son's treatment or if you just have questions about it, I'd encourage you to talk with your doctor or even considering getting a second opinion from a specialist.

Good luck,

Kathi