<human>: hi, my son has the following results and symptoms and would like to know what you think: At around 1 year of age George developed eczema with an unknown trigger. At 3 years of age he had a spell of wheezing when visiting friends who have a dog, and this re-occurred on subsequent visits. From age 4 onwards he began experiencing coughing, sneezing, wheezing, itchy eyes and congestion when going outdoors in spring and late summer. On numerous occasions between 6 and 9 years George had emergency breathing problems when going out in cold weather and especially during exercise. He had a cystic fibrosis sweat test, whicChatDoctore back negative. Wheal-and -flare responses were observed in response to dog dander and pollen. Full blood count: RBC = 4.0 x 1012/l, WBC = 13.0 x 109/l, Hb = 12.9 g/dl. Differential leucocyte count: Neutrophils 60%, Lymphocytes 20%, Eosinophils 1200/microlitre Lymphocyte enumeration: CD3 +ve cells 70%, CD19 +ve cells 15%, CD4 +ve cells 41%, CD8 +ve cells 25%. CH50 Total haemolytic complement: 130 haemolytic units Complement components: C3 1.1 g/l, C4 0.2 g/l Immunoglobulin and antibody tests: Serum IgG 1000mg/dl, IgM 180mg/dl, IgE 1750 IU/ml ( 150KUA/litre, or 20mg/dl), RAST positive (score 6) for dog dander and pollens. Thank you
<bot>: Hi, thanks for choosing Chat Doctor for your medical query. From the information that you have given me it turns out your child is severely allergic to dog dander and pollen. I inferred this from his history where he becomes symptomatic after exposure to these things SND also the fact that he has a high LAST score for them.LAST score is quite a reliable test, and we can confidently say these are the things he's allergic to. He also seems to have exercise induced asthma. Its reassuring that other grave diagnoses have been ruled out. The best treatment option is to acid exposure to dogs and pollen. Other than that you should start montelukast sachet 4 mg every day preferably at night. Montelukast will help stabilize his condition and his bouts of severe allergic reaction will be reduced. You should always keep short-acting beta agonists such as albuterol in the form of inhaler at hand. Your child has had episodes of bronchospasm which can be serious. Always contact your doctor if symptoms do not subside or are worse than usual. I will be happy to answer any more questions that you may have.