Dust mite allergy development

A 23-year-old man, with a history of asthma, house dust mite allergy, and rhinoconjunctivitis, presented with acute respiratory symptoms. He was given oral cetirizine, inhaled salmeterol, and fluticasone propionate, and oral prednisone 40 mg/day for 1 week and 20 mg/day for 1 week. His asthma recurred when prednisone was withdrawn and he took oral prednisone 60 mg/day for 1 week and 40 mg/day for 1 week. He also took montelukast 10 mg/day. He then developed severe peripheral edema with a gain in weight of 13 kg. Prednisone was withdrawn and his edema resolved. Montelukast was continued. 

Sporik R, Holgate ST, Platts-Mills TAE, Cogswell JJ Exposure to house dust mite allergy (Derp 1) and the development of asthma in childhood. N Engl J Med 1990 323 502—507. (Ila)... 

Yasueda H., Mita H., Yui Y. and Shida T. (1989) Measurement of allergens associated with dust mite allergy, I. Development of sensitive radioimmunoassays for the two groups of Dermatophagoides mite allergens, Der I and Der II. Int. Arch. Allergy Appl. Immunol., 90, 182-189. 

Lau S, llli S, Sommerfeld C, Niggemann B, Bergmann R, von Mutius E, Wahn U (2000) Early exposure to house-dust mite and cat allergens and development of childhood asthma A cohort study. Multicentre Allergy Study Group. Lancet, 356(9239) 1392-1397. 

House-dust mites in the genus Dermatophagoides (family Acaridae) are common in homes and are an important cause of the allergies that many people develop to house dusts. 

It is not uncommon for coughs to persist for several weeks in children after a chest infection. However, the child may have an allergy and be developing asthma. If so, the most likely cause is house dust mite or dander (fur particles) from a household pet. You should ask the mother for further clues for example is he worse in any particular room of the house, or worse after dust is raised, say with vacuuming or with changing the bed sheets Do any other family members suffer from asthma, hayfever or eczema On the other hand the child may have another viral upper respiratory tract infection, but as you are unable to decide the cause you should advise the mother to take him back to the doctor. 

Sears MR, Herbison GP, Holdaway MD, et al The relative risks of sensitivity to grass pollen, house dust mite and cat dander in the development of childhood asthma. Clin Exp Allergy 1989 19 419-424,... 

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