House CallOct/Nov 2011 Issue

Pediatric Allergies Q & A - Big Bites, Milk Allergy, and More!

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Hot and Bothered

Every time I go for a run or get sweaty, I start to break out and feel itchy all over. I don’t think it’s my clothing. I’ve tried changing my laundry detergent but it doesn’t seem to be helping. Is it possible to be allergic to your own sweat?

Dr. Jain You’re most likely experiencing cholinergic urticaria. People with this condition often develop itching and a rash when their body temperature rises or when they begin to sweat. Perspiring activates the parasympathetic nervous system, which releases a neurotransmitter called acetylcholine (thus the term, cholinergic) to help our bodies cool off. In some people, high amounts of acetylcholine prompt the development of hives and itching. Usually the symptoms are mild and go away on their own after a short time. Symptoms can sometimes be prevented by taking an antihistamine before exercising, a common trigger of the problem. Check with your doctor.

Bug Bites

Gnats, mosquitoes and biting flies really bother my husband. Their bites create lots of swelling on his skin. I’m worried that this may get more serious over time.

Dr. Jain Any insect bite has the potential to cause an allergic reaction, which can vary from mild and annoying to severe and potentially life threatening. I’ve personally seen patients develop life-threatening reactions after they accidentally swallowed a biting bug (one to which they were allergic) when they were out running. In most cases, however, bite reactions tend to be localized and don’t progress in terms of seriousness. That being said, you and your husband should keep an eye on his bites. If they seem to be getting more severe over time, consult an allergist who can test for allergies and provide treatment and prevention options.

Feeling Fatigued

I feel like I’m tired all the time. I have some sinus problems and I’m wondering if my tiredness could be related to allergies. Am I crazy?

Dr. Jain Sinus problems are often related to the allergic rhinitis that comes with allergies, particularly environmental and seasonal allergies (dust mites, animal dander, feathers, mold, pollen, etc.). Many patients who suffer from environmental allergies describe feeling fatigued. In some cases, “being tired” is the most prominent symptom that people report.

I tend to liken allergies to feeling like you have a cold that just won’t go away. You feel tired and weak with decreased ability to focus. When symptoms are present, both children and adults with environmental allergies have been shown to have difficulty with a variety of tasks, including school and work performance.

Fortunately, there’s hope. Identifying what you are allergic to and treating the symptoms will often provide relief. Options for treatment include avoiding allergens, taking allergy medications and allergen desensitization. Check with your doctor for diagnosis and treatment of your particular condition.

Outgrowing Milk Allergy

Are we any closer to being able to fix my son’s allergy to cow’s milk? The doctor said he’d outgrow it by age 2. He’s now 4 and still hasn’t outgrown it.

Dr. Jain Roughly 80 percent of kids who are milk allergic will outgrow the allergy by age 6. That leaves 20 percent who will not. Several studies now suggest that we can help increase the odds.

Most recently, a study in Italy demonstrated that children with cow’s milk allergy can be made to outgrow their allergy by gradually administering increasing doses of milk taken daily over an 18-week period. All the children given cow’s milk were able to increase the amount of milk they could tolerate, with most ingesting a 6-ounce dose without reaction by the end of the study. Unfortunately, two patients experienced severe reactions as their dose of milk was increased.

Study results offer hope for those kids, like your son, who don’t seem to be outgrowing their cow’s milk allergy. However, additional research is needed to address lingering questions, such as, is this desensitization permanent and how can we predict which patients won’t respond to it.

As a reminder, this type of food-allergy desensitization is under investigation and should never be attempted outside a controlled research setting.

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