As Dr Salena points out, asthma has not been completely excluded as a diagnosis in our case without use of the methacholine inhalation challenge test, even though eosinophilia, a positive family history of atopic disease, and an association between cough and β-blocker therapy were not observed.
The backgrounds of the patients should be carefully evaluated when the patients are considered to exhibit an adverse effect to a certain drug. On this point, asthma has to be discussed in our case, because asthmatic patients might be sensitive to the stimuli that produce the cough reflex.1
However, it is difficult to attribute the cough that developed after captopril treatment and subsided with its withdrawal entirely to asthma.
An association of cough with captopril can be acknowledged in our case, whatever the cough mechanisms or patients' backgrounds are.