Summer is here, and with the arrival of the heat waves, there comes the question every mother asks themselves in the pharmacy: does my child have allergies or is it something else? Learning to differentiate the symptoms of seasonal or environmental allergies from a sinus infection is something many parents struggle with. Particularly with everyone being hyper-conscious of upper respiratory symptoms since the pandemic began.
Initially, when the body is exposed to an allergen in its surroundings (medications, pollen, pet dander, dust, mold, or chemicals), the immune system responds. After the body has detected a perceived threat, lymphocytes, eosinophils and neutrophils flood the affected area. The immune response triggers receptors in the surrounding tissue that are responsible for releasing histamine. Histamine is the compound the body utilizes to contain the allergen and prevent it from spreading quickly. Over time the histamine response can become systemic and affect more than one area of the body.
Severe allergic response, referred to by physicians and first responders as anaphylaxis, is a serious condition that can result in death if not treated. Symptoms will quickly present as hives (wheals that are red with no expressible fluids or sebum), respiratory distress (wheezing, gasping for air, decreased pulse oximetry), and eventually lead to circulatory collapse. Common causes of anaphylaxis include bee stings or insect bites, peanuts or tree nuts, and latex products. Anaphylaxis requires immediate medical management with an epinepherine injection, followed by histamine blockers and corticosteroids. Pharmaceutical agents commonly utilized at prescription strength to address these symptoms are diphenhydramine (Brand name Benadryl) and cortisone preparations (Brand names include Prednisone, SoluMedrol, Decadron, and PediaPred).
In a much more common and milder respiratory reaction, this release of histamine causes the windpipe to constrict and create excess mucus and phlegm. You or your family member may develop a runny nose, cough, watery eyes and feel pressure across both sets of sinuses. Your body has four sinus cavities formed at birth: two maxillary sinuses(on either side of the nostrils extending over the cheekbones) and two ethmoid sinuses (on either side of the nasal bridge and over the brow bones).
So what is the difference between the body’s response to an allergen and a pathogen, like a virus, bacteria or fungus? The same initial immune response will happen, with defender cells rushing to the source of the perceived threat. But instead of only histamine being released in response to the pathogen, macrophages arrive to encase and destroy the pathogens in the tissue. In laboratory studies, your physician will see elevated neutrophils, white blood cells and lymphocytes. However, the eosinophil count will remain normal in the presence of an infectious agent, and antibodies (also called immunglobulins) IgE and IgG will not read as abnormally elevated.
Allergies are typically predictable responses to the environment. Your family may notice symptoms around certain changes of season, such as in the spring with an elevated pollen count as the trees begin to bud. Or when your family member handles an animal, like a dog or cat, then touches their face before washing their hands. Allergic responses also don’t cause an appreciable fever response while your immune system fights the allergen.
An infection, however, may cause fevers above 100.4 F as the infectious process is initially detected. While a fever will help eradicate an infection by literally “cooking” the germs or pathogens, a prolonged fever will lead to other complications. Dehydration, weight loss, elevated heart rate and increased respiratory effort are all secondary responses to a febrile episode. While adult patients can tolerate a fever fairly well for a couple of days, pediatric patients (children 17 and under) are much more susceptible to dehydration and should be managed according to your physician’s recommendations.
So when you are noticing that you or your family is experiencing predictable, regular and afebrile respiratory issues? It is time to consider allergies. Your pharmacist or general practitioner is a good first line resource to address common allergic reactions, but when over the counter options don’t work? It may be time to request a specialist consultation with a board certified allergist Ft. Lauderdale.
An allergist Ft. Lauderdale is a highly trained physician that specialize in the immune response. Allergists regularly treat patients at all ages, and help families manage diagnoses such as asthma, anaphylactic response, allergic dermatitis and eczema. But allergists may also see patients in conjunction with other specialties, and often contribute to treatment plans for rheumatoid arthritis, psoriatic arthritis, and other chronic autoimmune diseases such as lupus and multiple sclerosis.
If your family member has experienced a severe anaphylactic episode, or does not respond to over-the-counter or short term prescription strength histamine blockers, the allergist may recommend scratch testing. During a scratch test, the allergist applies small amounts of common allergens in a grid pattern over a large patch of skin. Commonly applied to the shoulderblades, the patient is then asked to remain prone while the doctor and nursing staff observe the grid for local reactions.
The severity of the skin response is documented, and then the physician can suggest medications and potentially use allergen desensitization injections. These shots are usually referred to as allergy shots in the community. Injections are administered monthly over a period of 3 or 4 years with gradually increasing exposure to the allergen(s). With careful monitoring by the allergist Ft. Lauderdale and his/her staff during this process, eventually the allergy symptoms are mitigated, in many cases completely.
But, we are still standing in the pharmacy aisle, and you are trying to decide what you need to buy. Considering all of the information you now know to be true, your allergist Ft. Lauderdale can help you decide on the right histamine blocker, fever reducer and/or corticosteroid for your individual needs.
When you are deciding on the best healthcare options for your family, a board certified allergist Ft. Lauderdale can be a fantastic resource for providing comprehensive treatment options which may or may not be available from your regular physician. As always, our practice is here to assist you on this journey to wellness, and look forward to discussing your concerns at your first appointment.