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krishnareddy84
@krishnareddy84

Posts: 6
Joined: Aug 24, 2018

Chronic Cough from more than 8 months for a 4yr old

Posted by @krishnareddy84, Mon, Sep 3 6:47pm

Hi.. We live in Houston. My Son is of age 4yrs. He is struggling with Chronic cough from more than 8 months. Initially we thought it is due to allergies in Houston. We started using 'Children's Zyrtec' in the month of January 2018. Cough and Sneezing will stop for about 24 hours if we use Zyrtec. We went almost 6 times to Physician but he could not able to figure out the reason for the cough. Doctor suggested to meet allergies specialist and we did so. Doctor conducted Full blood allergies profile test, Allergies skin test but they didn't find any major reactions to allergies from my son's body.

So, the cough may not be due to allergies. But surprisingly, it will stop for 24 hours only if we use 'Zyrtec'. No other medication is helping. Doctors also suggested to use 'Zyrtec' for two more months.

It is very hard to see 4yr old coughing and sneezing most of the time. Can someone please help us in finding the reason.

REPLY

Hello @krishnareddy84,

Welcome to Connect. As a parent, I can only imagine how worried you must be. I'm tagging Mentor @windwalker to see if she may have some thoughts about your son's symptoms. A few members (@egayle187) in the MAC & Bronchiectasis group on Connect have also recommended reading Dr. Jamie Koufman’s book,"The Chronic Cough Enigma." It has questionnaires to help find the cause of for each individual.

I encourage you to view this Mayo Clinic Video Q&A about Pediatric Lung Problems, https://connect.mayoclinic.org/webinar/video-qa-about-pediatric-lung-problems/ and I'd also like to invite @pfists @jenblalock @g3smith60 @kaystrand @irene5 and @bassman to join this discussion.

@krishnareddy84, may I ask if other causes like post-nasal drip or acid reflux have been ruled out?

@kanaazpereira

Hello @krishnareddy84,

Welcome to Connect. As a parent, I can only imagine how worried you must be. I'm tagging Mentor @windwalker to see if she may have some thoughts about your son's symptoms. A few members (@egayle187) in the MAC & Bronchiectasis group on Connect have also recommended reading Dr. Jamie Koufman’s book,"The Chronic Cough Enigma." It has questionnaires to help find the cause of for each individual.

I encourage you to view this Mayo Clinic Video Q&A about Pediatric Lung Problems, https://connect.mayoclinic.org/webinar/video-qa-about-pediatric-lung-problems/ and I'd also like to invite @pfists @jenblalock @g3smith60 @kaystrand @irene5 and @bassman to join this discussion.

@krishnareddy84, may I ask if other causes like post-nasal drip or acid reflux have been ruled out?

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Hello @kanaazpereira,

Thank you so much for your message. I am not sure whether post-nasal drop or acid reflux have been ruled out. I can check with Physician about this.

I can explain more on the recent tests and medications which Allergy specialist prescribed which might help you to understand more on the problem.

First doctor suggested to STOP using 'Zyrtec' before my son take allergy skin test. He prescribed below medication to use for 10 days and take test after that.

1. Amoxicillin and Clavulanate Potassium for oral suspension (250mg/62.5 mg per 5 ml)
2. Mometasone nasal 50 mcg/inh

After using these medications we gave Skin test, intradermals and below is the Result of the test they mentioned.

"negative to all tested (including dust mite, molds, grass, weed and additional tree pollens with a negative saline and positive histamine control"

Doctor suggested to continue Mometasone nasal 50 mcg/inh & Zyrtec for next two months and then appear again.

So we are currently using Mometasone nasal 50 mcg/inh & Zyrtec but as I mentioned earlier, it is not improving his condition. If we delay in giving Zyrtec, he will start coughing too much.

Once again than you so much for your message.

@pfists @jenblalock @g3smith60 @kaystrand @irene5 @bassman

@krishnareddy84

Hello @kanaazpereira,

Thank you so much for your message. I am not sure whether post-nasal drop or acid reflux have been ruled out. I can check with Physician about this.

I can explain more on the recent tests and medications which Allergy specialist prescribed which might help you to understand more on the problem.

First doctor suggested to STOP using 'Zyrtec' before my son take allergy skin test. He prescribed below medication to use for 10 days and take test after that.

1. Amoxicillin and Clavulanate Potassium for oral suspension (250mg/62.5 mg per 5 ml)
2. Mometasone nasal 50 mcg/inh

After using these medications we gave Skin test, intradermals and below is the Result of the test they mentioned.

"negative to all tested (including dust mite, molds, grass, weed and additional tree pollens with a negative saline and positive histamine control"

Doctor suggested to continue Mometasone nasal 50 mcg/inh & Zyrtec for next two months and then appear again.

So we are currently using Mometasone nasal 50 mcg/inh & Zyrtec but as I mentioned earlier, it is not improving his condition. If we delay in giving Zyrtec, he will start coughing too much.

Once again than you so much for your message.

@pfists @jenblalock @g3smith60 @kaystrand @irene5 @bassman

Jump to this post

Hello @kanaazpereira

Sorry to mention one more thing. His physician ruled out Asthma or pneumonia problems. We went more than 6 times in last 9 months and every time when Doctor checks with stethoscope, doctor mentioned he did not see any problem with lungs and no signs of Asthma or pneumonia problems.

So, in a summary, we are not able figure out the problem/reason for the cause which my kid is struggling from last 9 months.

@pfists @jenblalock @g3smith60 @kaystrand @irene5 @bassman

@krishnareddy84 Hello and welcome to our site. That has to be very disconcerting to have your child coughing and sneezing so much and not find answers. Was your home flooded by hurricane Harvie by any chance? Or your son's day care? Oftentimes; microbes are left in the woodwork that cause respitory issues. Maybe consider taking him to an Infectious Disease dr. Can also try restricting his diet for a few weeks, eliminate milk/dairy, eggs, and gluten (bread, flour, cereal, pasta) do one category at a time. It could be that he has a common food alergy. I know he had an allergy test that turned up nothing. I too had a constant cough and was given both kinds of allergy tests. No food allergies turned up on mine; but, I did the elimination diet and found that dairy and gluten was causing my cough. Keep searching for answers, Google all that you can, maybe get second or third opinions.

@windwalker

@krishnareddy84 Hello and welcome to our site. That has to be very disconcerting to have your child coughing and sneezing so much and not find answers. Was your home flooded by hurricane Harvie by any chance? Or your son's day care? Oftentimes; microbes are left in the woodwork that cause respitory issues. Maybe consider taking him to an Infectious Disease dr. Can also try restricting his diet for a few weeks, eliminate milk/dairy, eggs, and gluten (bread, flour, cereal, pasta) do one category at a time. It could be that he has a common food alergy. I know he had an allergy test that turned up nothing. I too had a constant cough and was given both kinds of allergy tests. No food allergies turned up on mine; but, I did the elimination diet and found that dairy and gluten was causing my cough. Keep searching for answers, Google all that you can, maybe get second or third opinions.

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@windwalker Thank you so much for your reply. We live in an apartment complex and it was not flooded by hurricane Harvey. Also, we moved to other apartment complex four months back.

We will try eliminate each food item one at a time and see if that helps. Thank you so much for your advice.

@krishnareddy84 Hello. I have another suggestion for you. Ask the doctor to test your son for haemophilus-influenzae. It is not the flu, but is a bacterial infection. May want to have an induced sputem test to see what if anything is in his lungs. There are many things that could be lurking in them.

@windwalker

@krishnareddy84 Hello. I have another suggestion for you. Ask the doctor to test your son for haemophilus-influenzae. It is not the flu, but is a bacterial infection. May want to have an induced sputem test to see what if anything is in his lungs. There are many things that could be lurking in them.

Jump to this post

Thanks @windwalker . I will ask doctor about this test and see if they can do this. Thanks for the suggestion.

@krishnareddy84

Hello @kanaazpereira

Sorry to mention one more thing. His physician ruled out Asthma or pneumonia problems. We went more than 6 times in last 9 months and every time when Doctor checks with stethoscope, doctor mentioned he did not see any problem with lungs and no signs of Asthma or pneumonia problems.

So, in a summary, we are not able figure out the problem/reason for the cause which my kid is struggling from last 9 months.

@pfists @jenblalock @g3smith60 @kaystrand @irene5 @bassman

Jump to this post

@krishnareddy84 Hi, friend. I and my brother and sisters all have the same problem. Chronic cough. Mayo says it is from chronic eosinophilic esophagites and other eosinophil overload in trachea and esophagus and larynx. Ask your doc to order an assay of eosinophils. It is an autoimmune thing, and related to Barrett's Esophagus and Lung issues which will come on slowly. They will probably not show up for another 10 or 20 years on biopsy, etc. old karl.

Hi, Welcome to Connect. I have been following your post. My heart is with you and your son as you search for answers to his cough.
I can relate with my personal journey and also with children I have known. I hope this helps some.
I had the very same issue you describe along with some of the same recommendations. It wasn’t until I went to a big research center, Mayo Clinic, and saw thorasic and pulmonologist who properly diagnosed me with a CT scan. Then I was properly treated.
You live near MD Anderson don’t you? Have you seen lung specialist there?
This is not to frighten you, but in my journey with lung cancer, I have met children ages 3, 7, 8, & 20
who were diagnosed with lung cancer.
Local Doctors all thought (for two or more years) we had asthma.
We were all active and seemingly very healthy before our proper diagnosis. I did a TED X Talk Beating The Odds and Summiting Kilimanjaro with One Lung. My lung journey has made me passionate about Saving Lungs & Lives encouraging people to tell their doctors anybody can get the silent killer lung cancer. I will continue to follow your story. It’s better to request a CT scan and see what’s going on in lungs!
Please stay connected. I’m sending silent blessings. All my best.

@krishnareddy84

@windwalker Thank you so much for your reply. We live in an apartment complex and it was not flooded by hurricane Harvey. Also, we moved to other apartment complex four months back.

We will try eliminate each food item one at a time and see if that helps. Thank you so much for your advice.

Jump to this post

@krishnareddy, You're welcome. Will you please keep me posted about your son? Hugs to your little guy.

Hi,

We went to my son physician again for the same problem. He also suggested to continue 'Zyrtec' for few more months. He also mentioned not to worry about using 'Zyrtec' for long time as it will not reach brain.

We were keep asking the reasons for the cough and he mentioned it could be due to high levels of 'histamine' in his body. It is hard to identify exact reason for 'histamine' but it can go over the period is what he mentioned. 'Zyrtec' can stop or disable the impact of 'histamine' in body. He also mentioned that 'Zyrtec' cannot control other issues like if any problem in lungs or so if that is the reason for the cough. As cough is getting controlled by 'Zyrtec' only, he said 'histamine' could be the problem.

Need your help in understanding more about 'histamine'.

@windwalker @pfists @jenblalock @g3smith60 @kaystrand @irene5 @bassman

@krishnareddy84

Hi,

We went to my son physician again for the same problem. He also suggested to continue 'Zyrtec' for few more months. He also mentioned not to worry about using 'Zyrtec' for long time as it will not reach brain.

We were keep asking the reasons for the cough and he mentioned it could be due to high levels of 'histamine' in his body. It is hard to identify exact reason for 'histamine' but it can go over the period is what he mentioned. 'Zyrtec' can stop or disable the impact of 'histamine' in body. He also mentioned that 'Zyrtec' cannot control other issues like if any problem in lungs or so if that is the reason for the cough. As cough is getting controlled by 'Zyrtec' only, he said 'histamine' could be the problem.

Need your help in understanding more about 'histamine'.

@windwalker @pfists @jenblalock @g3smith60 @kaystrand @irene5 @bassman

Jump to this post

Some very common allergens that make our little ones release histamine are: pillows that are not covered by an allergy proof, zippered covering, mattress, box springs, same thing. All collect dust. Curtains, bedspreads, rugs, carpet. All collect dust mites.

Peanuts and peanut butter, eggs, strawberries, wheat products, fish. You could try keeping a food diary for your little one. To give a daily account of the foods he eats. Sometimes this helps your Pediatrician figure out what allergies to test for.

I myself am not only allergic to common foods, but trees, grasses, plants….the list goes on and on. At some point He or She will want to test your little love for allergies

Good luck! Take good care and let me (and us) know how you are doing.

Mamacita

Liked by krishnareddy84

@krishnareddy84 – Wow, that's surprising that his allergy skin test was negative for everything. I believe (although I'm not an expert by any means) that that might indicate his issue may be more infectious or immunological. Here's some things to consider:

1. Home remedies to at least help relieve symptoms: Two thumbs up to @mamacita's suggestion of investing in an allergy-specific mattress cover and pillow protectors (look specifically for a mattress/pillow encasements for the most complete protection; I looked at this one — https://amzn.to/2NINiT7 — because it includes a zip-off top to allow you to wash it often and easily, also important for allergy control, and it would be a good fit for you as it's also supposed to be waterproof for any bed-wetting incidents). You may wish to try a humidifier, especially being in Houston's dry air (just be sure to clean it fairly frequently/weekly to prevent any sort of mold/bacterial growth) and/or air purifier (HEPA filters are often recommended for those with allergies/asthma, both in an air purifier and in your vaccuum). Check with your apartment complex to verify when your air filter was last replaced (unless the system is in your apartment that you can check it yourself), and consider asking if you could replace replace the generic cheap one that's likely in there with a HEPA/allergy emphasis model.

2. I second the note about testing his eosinophils/basophils; if he hasn't already he should have a CBC (complete blood count) and CMP (complete metabolic panel) done. I would also suggest asking about having his tryptase levels tested as a possible early manifestation of some type of mast cell activation disorder, which is where your body overreacts to a variety of triggers, and not always the same ones (read more about tryptase at https://labtestsonline.org/tests/tryptase); a 24-hour urine histamine test can also give an idea of his levels over a longer period of time (note, you'll want to check about how Zyrtec might affect the results of these tests). You might also ask about a trial of Singulair instead of and/or in addition to the Zyrtec; it treats for allergies/asthma in a different way.

3. I also recommend requesting a referral to an immunologist to explore some type of immune deficiency/issue (note this is different than a rheumatologist/autoimmune issues); you'll want to ask about testing his immunoglobulins, particularly IgE and IgA if he hasn't been already (learn more at https://labtestsonline.org/tests/total-ige and https://labtestsonline.org/tests/quantitative-immunoglobulins). Ask also about a pneumococcal serotope blood test, which can help identify either a recent/current pneumonia infection, a general immunodeficiency disorder or a selective antibody deficiency (learn more at https://www.merckmanuals.com/home/immune-disorders/immunodeficiency-disorders/selective-antibody-deficiency-with-normal-immunoglobulins).

4. Check and find out if he's current on his vaccinations to make sure he's not at risk for something like pertussis (the immunologist will also want/need to know this for the tests above), and/or whether he's had any vaccinations recently that he may be slightly reacting to (very rare).

5. A referral to an ENT (ear, nose and throat doctor) may provide insight, especially if there's some kind of structural issue at fault. He/she may order a CT of the face and sinus and examine your son's tonsils.

6. If none of the above provide any answers/relief, next up would be a check with an infectious disease specialist to rule out something like some sort of fungal infection like blastomycosis or, on the more unlikely end of the spectrum, TB. He or she may want to do a sputum test as mentioned by someone else, and/or a chest x-ray or CT scan.

That's all I can think of at the moment, but feel free to keep us posted on any results that might prompt new possibilities. Your son is very lucky to have you as his advocate; I wish you both the best of luck and happier health soon.

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