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I have looked through your reports (attachment removed to protect patient identity). Also, I wish to know the following details to make a more decisive diagnosis.
1. Regarding breathing problems and eosinophilia, what was the breathing trouble you had in the past?
2. What medicine did your doctor prescribe for you? If you have any reports or prescriptions or tests kindly attach those in the next query.
3. How many times do you sneeze per day? Do you smoke or drink?
4. Are you working? If so what are the atmospheric conditions at your workplace? Do you get exposed to dust, smoke, pollen, winds, etc?
5. Do you have a running nose or itching of the nose or eyes and watering of eyes along with sneezing?
You appear to have allergic rhinitis. Also in the past, the breathing trouble could have been asthma. Asthma and allergic rhinitis are related and occur together in many patients. However, I cannot be sure of the diagnosis until I see your past reports.
You should go for an IgE antibody test. An elevated IgE antibody suggests allergic rhinitis. Your complete blood count and sputum reports are normal. The absolute eosinophil count and eosinophil percent are normal. The spirometry has a mild abnormality. You have moderate lung restriction, but that is not the cause of your sneezing. This restriction most probably could be a result of the breathing trouble you suffered in the past.
The medications given by your doctor are fine. Those will be the same that I would also give. Some suggestions I would like to make are as follows:
1. Nazomac M spray (Mometasone furoate) should be taken twice daily for two weeks and then daily once for a month.
Each time you should spray both nostrils. When you spray on the right nostril using your left hand and on the left nostril spray with your right hand. Note that the spray should be directed mildly towards the sides of the nose and not the center that is why I have asked to use different hands. The spray should be taken for a long duration, it takes time to act. Also after the spray do not forcefully inhale it. It should remain in the nose.
2. Take Montemac 10 mg (Montelukast) once a day for another 10 days.
3. Take Cetirizine 10 mg only when sneezing is severe. If you feel drowsy, you can take Fexofenadine 120 mg or Levocetirizine 5 mg.
Allergy is not curable. It points to some form of hypersensitivity by your body to some daily routine substances which do not produce allergies in other persons.
However, with the right precautions and care, you can avoid occurrences of allergic symptoms. Also with the right treatment, you can prevent any severity of the symptoms.
The Probable causes:
1. Smoke, cold winds, pollen, dust mites.Investigations to be done:
2. Passive smoke and burning substances.
3. Food allergy can be due to milk, nuts, prawns, soy, etc.
Take a diary and maintain your daily activities. Write down meticulously the food you eat also. Suppose you get allergy one day, you note down and see if there was anything suspicious you did because of which you might have developed the allergy. This will help in avoidance of the suspected allergen.
Send me all reports regarding your past history.Differential diagnosis:
1. Allergic rhinitis.Treatment plan:
2. Non - Allergic rhinitis with eosinophilia syndrome.
Follow the same treatment plan that your doctor has given in his prescription with the suggestions that I have made above.Preventive measures:
1. No smoking or passive smoking.Regarding follow up:
2. Drink plenty of lukewarm water. Drink four to five liters of water daily.
3. Avoid cold drinks, alcohol and aerated cool drinks. Take meals hot rather than cold.
4. If working in dust atmosphere try changing your workplace. If not possible wear a mask that prevents inhalation of pathogens.
5. Maintain a diary and consciously note down any incident or food products that triggers allergy.
6. Dry your hair soon after hair wash. Do not apply oil for long duration.
7. Eat nutritious food rich with all vitamins and minerals.
8. For a month take multivitamin supplements such as Himalaya Septillin or AtoZ capsules are good brands.
9. Take plenty of green leafy vegetables, gooseberry every alternate day if not daily, very rich source of Vitamin C.
Revert back with the reports to an allergy specialist online.---> https://www.icliniq.com/ask-a-doctor-online/allergy-specialist