{"id":34807,"date":"2021-11-18T15:36:53","date_gmt":"2021-11-18T15:36:53","guid":{"rendered":"https:\/\/www.mymsd.ch\/fr\/?page_id=34807"},"modified":"2025-11-23T20:46:19","modified_gmt":"2025-11-23T20:46:19","slug":"toux-chronique","status":"publish","type":"page","link":"https:\/\/www.mymsd.ch\/fr\/toux-chronique\/","title":{"rendered":"Toux Chronique"},"content":{"rendered":"\n
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DE<\/a><\/div>\n\n\n\n
FR<\/a><\/div>\n<\/div>\n\n\n\n
\"Man<\/figure>\n\n\n\n

Chez l\u2019adulte, la toux chronique<\/mark>
se d\u00e9finit par sa dur\u00e9e.[1]<\/sup><\/h1>\n\n\n\n
<\/div>\n\n\n\n
\"Timeline<\/figure>\n\n\n\n
<\/div>\n\n\n\n

Si, malgr\u00e9 un traitement et des examens m\u00e9dicaux adapt\u00e9s, votre patient pr\u00e9sente toujours une toux chronique, il faut envisager de poser un diagnostic de toux chronique r\u00e9fractaire (refractory chronic cough, RCC) ou de toux chronique inexpliqu\u00e9e (unexplained chronic cough, UCC).[2-4]<\/sup><\/p>\n\n\n\n

\n
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\"Stethoscope<\/figure>\n\n<\/div>\n\n\n
\n \n\n

Diagnostic<\/mark><\/h2>\n\n\n\n

Dans le diagnostic de la toux chronique, l\u2019approche par \u00e9tapes a fait ses preuves. Le diagnostic initial repr\u00e9sente la premi\u00e8re \u00e9tape, qui est incontournable chez les patients pr\u00e9sentant une toux chronique. Le diagnostic initial comprend une anamn\u00e8se d\u00e9taill\u00e9e, un examen clinique et fonctionnel des poumons, ainsi qu\u2019une radiographie du thorax.[1,5]<\/sup><\/p>\n\n\n\n

<\/p>\n\n\n

\n \n En savoir plus<\/span>\n <\/a><\/div>\n\n<\/div>\n\n <\/div>\n\n <\/div>\n\n <\/div>\n<\/section>\n\n\n
\n
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M\u00e9canisme pathologique<\/mark><\/h2>\n\n\n\n

Contrairement \u00e0 un r\u00e9flexe de toux protecteur en r\u00e9action \u00e0 un stimulus m\u00e9canique, comme des particules inhal\u00e9es ou une aspiration de nourriture ou \u00e0 un r\u00e9flexe d\u00fb \u00e0 la diminution du pH,[6,8-10]<\/sup> les RCC\/UCC surviennent par le biais de m\u00e9diateurs inflammatoires, de mol\u00e9cules de signalisation ou de produits chimiques irritants.[6,7,9,11]<\/sup><\/p>\n\n\n

\n \n En savoir plus<\/span>\n <\/a><\/div>\n\n<\/div>\n\n\n
\n \n\n
\"lung<\/figure>\n\n<\/div>\n\n <\/div>\n\n <\/div>\n\n\n
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\"icon<\/figure>\n\n<\/div>\n\n\n
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Patients et qualit\u00e9 de vie<\/mark><\/h2>\n\n\n\n

Les patients pr\u00e9sentant une toux chronique r\u00e9fractaire ou une toux chronique inexpliqu\u00e9e suivent un chemin p\u00e9nible vers le diagnostic. Ils peuvent avoir l\u2019impression que leur \u00e9tat n\u2019est pas vraiment trait\u00e9, car ils passent de m\u00e9decin en m\u00e9decin, tout en continuant de souffrir d\u2019une toux chronique, qui alt\u00e8re leur qualit\u00e9 de vie.[4,12,13]<\/sup><\/p>\n\n\n

\n \n En savoir plus<\/span>\n <\/a><\/div>\n\n<\/div>\n\n <\/div>\n\n <\/div>\n\n\n\n

Quiz: Que savez-vous sur
la toux chronique?<\/mark><\/h2>\n\n\n
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\"Graphic<\/a><\/figure>\n\n<\/div>\n\n <\/div>\n\n <\/div>\n\n\n\n
\n\t
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La toux est un r\u00e9flexe fondamental de protection contre les irritations des voies respiratoires. Si la toux dure plus de 8 semaines, on parle de toux chronique, qui peut alt\u00e9rer la qualit\u00e9 de vie li\u00e9e \u00e0 la sant\u00e9 des patients.[1,12]<\/sup><\/strong><\/p>\n\n\n\n

\n
Abonnez-vous pour recevoir des nouvelles concernant la toux chronique<\/a><\/div>\n<\/div>\n\n <\/div>\n<\/section>\n\n\n
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\"Icon<\/figure>\n\n\n\n

Profil des patients<\/strong><\/strong><\/h4>\n\n\n\n

Un patient pr\u00e9sentant une toux chronique se pr\u00e9sente g\u00e9n\u00e9ralement avec une toux qui dure depuis plus de 8 semaines.[1,12]<\/sup><\/p>\n\n\n

\n \n En savoir plus ><\/span>\n <\/a><\/div>\n\n<\/div>\n\n\n
\n \n\n
\"Icon<\/figure>\n\n\n\n

M\u00e9canisme pathologique<\/strong><\/h4>\n\n\n\n

Contrairement \u00e0 un r\u00e9flexe de toux protecteur en r\u00e9action \u00e0 un stimulus m\u00e9canique, comme des particules inhal\u00e9es ou une aspiration de nourriture ou \u00e0 un r\u00e9flexe d\u00fb \u00e0 la diminution du pH,[6,8-10]<\/sup> les RCC\/UCC surviennent par le biais de m\u00e9diateurs inflammatoires, de mol\u00e9cules de signalisation ou de produits chimiques irritants.[6,7,9,11]<\/sup><\/p>\n\n\n

\n \n En savoir plus ><\/span>\n <\/a><\/div>\n\n<\/div>\n\n\n
\n \n\n
\"Icon<\/figure>\n\n\n\n

Diagnostic<\/strong><\/h4>\n\n\n\n

Pour diagnostiquer une toux chronique r\u00e9fractaire \/ toux chronique inexpliqu\u00e9e et aider les patients \u00e0 mieux comprendre leur \u00e9tat, l\u2019approche par \u00e9tapes a fait ses preuves.[1,5]<\/sup><\/p>\n\n\n

\n \n En savoir plus ><\/span>\n <\/a><\/div>\n\n<\/div>\n\n <\/div>\n\n <\/div>\n\n\n\n
\n\n\n\n
R\u00e9f\u00e9rences:<\/strong><\/h5>\n\n\n\n
    \n \n
  1. \n Morice AH, Millqvist E, Bieksiene K, et al. ERS guidelines on the diagnosis and treatment of chronic cough in adults and children. Eur Respir J 2020;55(1):1901136. <\/li>\n\n\n
  2. \n Irwin RS, French CL, Chang AB, Altman KW; CHEST Expert Cough Panel. Classification of cough as a symptom in adults and management algorithms: CHEST Guideline and Expert Panel Report. Chest 2018;153(1):196-209. <\/li>\n\n\n
  3. \n Gibson P, Wang G, McGarvey L, et al. Treatment of unexplained chronic cough: CHEST Guideline and Expert Panel Report. Chest 2016;149(1):27-44. <\/li>\n\n\n
  4. \n Mazzone SB, McGarvey L. Mechanisms and Rationale for Targeted Therapies in Refractory and Unexplained Chronic Cough. Clin Pharmacol Therapeut 2020. Epub ahead of print. Doi: 10.1002\/cpt.2003. <\/li>\n\n\n
  5. \n AWMF (Deutsche Gesellschaft fu\u0308r Pneumologie und Beatmungsmedizin e.V. [DGP], Deutsche Gesellschaft fu\u0308r Allgemein- und Viszeralchirurgie e.V. [DGAV]). S2k-Leitlinie der Deutschen Gesellschaft fu\u0308r Pneumologie und Beatmungsmedizin zur Diagnostik und Therapie von erwachsenen Patienten mit Husten. Stand 01.01.2019. AWMF-RegisterNr.: 020-003.<\/mark> <\/li>\n\n\n
  6. \n Mazzone SB, Undem BJ. Vagal Afferent innervation of the airways in health and disease. Physiol Rev 2016;96:975-1024. <\/li>\n\n\n
  7. \n Canning BJ, Chang AB, Bolser DC, et al on behalf of the CHEST Expert Cough Panel. Anatomy and Neurophysiology of Cough. CHEST Guideline and Expert Panel Report. CHEST 2014;146(6):1633-1648. <\/li>\n\n\n
  8. \n West PW, Canning BJ, Merlo-Pich E, Woodcock AA, Smith JA. Morphologic Characterization of Nerves in Whole-Mount Airway Biopsies. Am J Resp Crit Care Med 2015;192(1):30-39. <\/li>\n\n\n
  9. \n Sun H, Kollarik M, Undem BJ. Blocking voltage-gated sodium channels as a strategy to suppress pathological cough. Pulm Pharmacol Ther 2017;47:38-41. <\/li>\n\n\n
  10. \n Canning BJ. Functional implications of the multiple afferent pathways regulating cough. Pulm Pharmacol Ther 2011;24:295-299. <\/li>\n\n\n
  11. \n Mazzone SB, Chung KF, McGarvey L. The heterogeneity of chronic cough: a case for the endotypes of cough hypersensitivity. Lancet Respir Med 2018;6(8):636-646. <\/li>\n\n\n
  12. \n Satia I, Badri H, Al-Sheklly B, Smith JA, Woodcock AA. Towards understanding and managing chronic cough. Clin Med (Lond) 2016;16(Suppl 6):s92-s97.<\/mark> <\/li>\n\n\n
  13. \n Chamberlain SA, Garrod R, Douiri A, et al. The impact of chronic cough: a cross-sectional European survey. Lung 2015;193(3):401-408.<\/mark> <\/li>\n\n<\/ol>\n\n\n\n

    Il est possible de demander, si n\u00e9cessaire, des copies des publications mentionn\u00e9es \u00e0 l\u2019adresse dpoc.switzerland@msd.com<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

    Chez l\u2019adulte, la toux chronique se d\u00e9finit par sa dur\u00e9e.[1] Si, malgr\u00e9 un traitement et des examens m\u00e9dicaux adapt\u00e9s, votre 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