Dr. Shyam Kalyan. N
Otolaryngology (E.N.T)
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
My 13-year-old daughter has had seasonal allergies since the age of eight. Two years ago, she had a mild allergic reaction after eating raw apples, which we were told was oral allergy syndrome. She has recently had mild reactions to cherries, oranges, and snap peas. A few days ago, she had an allergic reaction at school that she believes was from applesauce. She developed hives on her face. We have an appointment with an allergist next month, but I am wondering what I can do to minimize the risk while we are waiting for an appointment. She is avoiding apples and other foods that she thinks she reacted to. Since she seems to have developed new reactions to other foods, I cannot really know what those would be in advance. Would dosing with an antihistamine daily be appropriate and helpful?
Hello,
Welcome to icliniq.com.
Can you describe the symptoms of allergy in detail and also the severity? Does she have breathing difficulty, puffiness of the face, swelling over the body, or a gastric discomfort like flatulence? Did she get any blood test done before like IgE or any antibody test?
Antihistamines can be taken. There is no harm if she is feeling better after taking them.
Patient's Query
Hi doctor,
Thank you for the reply,
She has had a reaction at home to apples which involved a rash around the mouth and itching inside the mouth. She was given Zyrtec, and the reaction was gone within 15 minutes. I did not witness the reaction that just occurred at school to what she believes was applesauce, but I was told that, in addition to the itching in the mouth and a rash around her mouth, she had hives on her face. There were no breathing difficulties. The nurse did not mention swelling, but she was given ice packs to her face. She did not have any gastric symptoms. She has not had any allergy testing.
Thank you.
Hello,
Welcome back to icliniq.com.
The most definite thing to be done is to run a skin prick test or immunoCAP blood test to see what is the offending agent. Skin prick tests are the most reliable, but these days blood allergy testing has also improved. Blood allergy testing involves a single prick and withdrawal of a blood sample. Skin prick test involves one prick for each allergen being tested. However, the prick is very minute and we use a special thin lancet for the same.
Regarding the use of Zyrtec (Cetirizine) and other antihistamines, I feel they are not required unless she develops any such allergy. It is advisable to have the medicine always with you whenever you travel. The best solution to this problem, till you meet your allergist, is to avoid what you think is the offending agent.
I suggest she try taking Montelukast (Singulair 10 mg) one tablet once daily. The dosage depends on her weight. If she is around 66.1 pounds, then 5 mg is sufficient. This helps in preventing allergies. It is a leukotriene antagonist that removes leukotriene which mediates an allergy.
I hope this reply is helpful. Do revert if you need any further support.
Regards.
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Otolaryngology (E.N.T)
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