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Sunday, April 20, 2014
Since my daughter was 3, everytime she gets a cold, she always end up with what I call "coughing episodes", the cough she gets could last 1-2 weeks after the cold is gone. Recently the coughing has gotten worse especially at night, she ends up coughing continuously for a period of an hour or so and there is nothing that makes her stop coughing. Her heart beats very very fast and makes us very nervous. Depending on the Dr, she has either Asthma, Bronchiolitis, or other type of problem, and normally she is given Albuterol or Pulmicort for the nebulizer, and another drug such as Singulair, Claritin, etc. Until now no one has told exactly what the problem is and what the solution is. During her last episode, I recalled that when she was born she had a reddish spot (size of dime) in her neck and the Dr told us that she had a mild case of Mastocytosis (Urticaria Pigmentosa) and that it would go away after 2 years, in effect this was the case after 2 years the spot went away. I have started researching and found out that the Mastocytosis could also be internal and this type of cells generate histamine, is it possible that this is the problem with my daughter? Is there a correlation? Can someone please tell me what my daughter has, I just do not buy that everytime I go to the Doctor and she has the same symptoms, the problem is different. I do not want to continue giving her Albuterol or any other drug for that matter, unless I know exactly that I am not shooting in the air. Your help is greatly appreciated!!!. If it is not too much to ask, would you please recommend a Pulmonologist in the Miami FL area?
There are a number of possible reasons a child might have recurring and prolonged bouts of coughing. The most common, and most fitting with the pattern you describe, is asthma. Making a diagnosis of asthma in a 3 year old child is often challenging - it involves detecting a combination of typical symptom pattern, typical responses to medications, and absence of other likely causes. Making this connection requires a physician to look at the entire long term history - not just the symptoms seen on one particular day.(Diagnosis such as "bronchiolitis" or "bronchitis" or even "sinus infection" would all make sense for just an individual bout of your child's illness . . . and might be why you're hearing these diagnoses mentioned. It's recognition of the repeated nature of the problem that leads to the consideration of an asthma diagnosis.)I don't think the mastocytosis is connected to the current respiratory problems.You should consider making an appointment between illnesses to talk to your primary care doctor about the possibility of asthma or some other underlying issue. (Sometimes during "acute illness" visits the symptoms at the moment get all the attention - and not the bigger picture.) If this doesn't help clarify matters, you could ask for a referral. I don't personally know any of the pediatric pulmonary specialists in Miami, but I do know there is a group at Miami Children's Hospital.
Elizabeth D Allen, MD
Clinical Associate Professor of Pediatrics
College of Medicine
The Ohio State University