Can he have a hypersensitivity to inhaled cortecoids after 2 years of taking them

[Sbolger1]

Hi everyone, my son is 5 and for the past year he has had a constant cough, he got this cough while on flixotide the orange inhaler and singular he was on these for two years , so he got this cough at Xmas and I noticed everytime I gave him his inhaler he was worse (throat clearing, coughing, couldn't jump around without choking) so doctor changed it to seretide, as soon as he got the blast of seretide he coughed non stop for 6 hours never used that again, so I took him off all inhalers eventually the throat clearing stopped but the cough was still there, respiratory specialist did no tests just gave me an 8 week course of azithromycin and told me to put him back on flixtoide when it was finished, the azythromycin worked for about 3 weeks and cough came back, I then got a lung xray done for him, it came up mild swelling of both lungs which is seen in reactive airway disease? So they said put him back on inhaler, so I did, 3 days in and his cough is worse hes back throat clearing and cant even jump without coughing, child has never had a wheezing episode or has never been breathless, can he be allergic to the steroid inhalers? I also switched to brown inhaler before and had same problem, he has never been actually tested for asthma they just think he could have it, any advice would be great.

[AxKlein89]

Most, if not all allergic reactions to steroids are not actually to the medicine itself but to other ingredients in the compound. Steroid inhalers are laboratory copies of the hormone cortisol, which the body produces naturally, so there's no such thing as an allergy to our own hormones.

Based on this information, it seems like your child is either reacting to something in the inhaler or has an underlying illness and the inhalers are unmasking it or making it worse. Steroids tamper with the immune system, so this could also be a problem.

It is best to consult with a doctor and have tests done.

[twinkly29]

I think some people find it's not the steroids themselves that are the issue but the propellant in the MDI inhalers (those you press). Not an allergy or sensitivity as such but like it irritates the airways/causes a reflex coughing action. I assume, being 5, he uses a spacer which is meant to reduce this but of course for some it still happens. Has he tried dry powder inhalers (DPI), ones you turn/click to load? Might be worth a go if not.

As an aside, the amount of steroids in the inhalers doesn't affect the immune system (and inhaled steroids work differently to oral ones) so it's unlikely to be an immune system issue.

[bess7771]

inhaled preventers commonly have side effects like this...irritated throat and top of trachea, its a damned nuisance and i very much sympathise.

[Gareth57]

I would think your starting point should be to get your son tested and confirm the diagnosis, or if you have a peak flow meter do the reversibility test yourself to see if he is asthmatic.

[Sbolger1 in reply to Gareth57]

Im on the waiting list since last December, to go private is so so expensive, nd ventolin doesn't work for him, 6 puffs every 4 hours does nothing

[Poobah in reply to Sbolger1]

6 puffs of Ventolin every 4 hours is quite a high dose if that's being given regularly. You say "puffs" which indicates an aerosol inhaler. It could be that your son is sensitive to the propellant in his inhalers. If you take his peak flow first thing, then let him take his inhalers, wait 20 minutes and repeat the peak flow. If it declines it may be an indication that there is a sensitivity to the aerosols. This sensitivity is also linked to a sensitivity to salicylate. More info here allergylink.co.uk/allergy-b...

The Azithromycin can act as an anti-inflammatory but if your son still had inflammation after his two month course then something else is going on. As you say, waiting for an appointment with a specialist is currently a waiting game but taking along a diary of symptoms and peak flow results will help.

[Sbolger1 in reply to Poobah]

I did get him a full allergy test done which showed an allergic reaction to feathers and an small intolerance to rice, he also has non allergic rhinitis, I actually don't own a peak flow monitor I will have to buy one and see what happens thank you

[twinkly29 in reply to Sbolger1]

You might find that it's not very reliable at the moment as he's only 5. That's not to say don't start doing it as it's good to start at some point but as a new thing with a 5 year old it might not show "the answer" right now.

[Sbolger1 in reply to twinkly29]

Thanks so much for all the information im actually more effected then he is it drives me crazy

[twinkly29 in reply to Sbolger1]

The Asthma UK nurses might be able to help - with possible conundrums, with peak flow etc with a young child etc.

AUK helpline - 0300 2225800 Mon-Fri, 9am-5pm

[madamestephens]

I don't know about lots of the details here (possible allergies etc) but I do know my 5 year old's constant cough (every night for hours for 6 months+) settled down once he got Montelukast tablets added to his inhaler prescription.

[Sbolger1 in reply to madamestephens]

He was on singular for two years when he got this cough that never went away so I took him off all treatment because it wasn't helping and nkw back on it but worse when he takes the steroid inhaler