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How is antihistamine toxicity treated ?

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ENT Specialist
Practicing since : 1991
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This weekend while cleaning out my basement I found some mold behind a freezer it wasnt alot of mold I sprayed it down with bleach and cleaned it up ...then I also cleaned up a back room where our furnace husband had put a whole winters worth of chimney ash in a wastebasket then put trash on top of it. I dumped the trash barrel into a bag and a bunch of ash dust went everywhere. I wasnt wearing a mask. About 3 hours later I started to feel like i was getting a sinus infection. 24 hours later I am finding it increasingly difficult to breath my lungs feel like they are burning as well as my throat and I cant smell anything. could something i have come in contact with be making me sick. I am a 35 year old women who just got off of prednisone for severe hives as well as uticaria vasculitis and I also have hashimotos as well.
Posted Sun, 29 Apr 2012 in Medicines and Side Effects
Answered by Dr. Sumit Bhatti 9 hours later

Thank you for your query.

1. First of all, it seems that you are suffering from antihistamine toxicity. Many of the symptoms mentioned by you such as chronic problems with urges to urinate as well as muscle weakness, blurry vision, bruising, low vitamin D, nasal ulcers and mouth ulcers may be caused by antihistamine (anti-allergy) medication. You are currently on 300 mg/day of Hydroxyzine (as against a maximum daily dose of 600 mg/day) and Zyrtec (cetrizine) 20 mg/day (as against a maximum daily dose of 10 mg/day, assuming that you are not having 5 mg tablets). Both these drugs are antihistamines.

2. Azo urinary pills can also cause breathlessness and skin rash. There is no problem with levothyroxine, however thyroid problems may also lead to being out of breath. Do you know your thyroid levels and the status of your hashimoto's thyroiditis?

3. Fungal infections may arise through absorption through the lungs such as with aspergillosis, however most fungi are not pathogenic in an immunocompetent host. Your physicians may need to do chest x-rays and a host of tests to determine such a problem. Lupus (may be drug induced) and MS may be ruled out by additional investigations (Contrast MRI and CSF examination).

4. If your breathlessness or burning in the lungs is due to ash exposure, usually it should not be XXXXXXX as ash is inert, and unless the exposure was large amount. Exposure to fumes from the bleach may also add to the problem.

5. If you continue to feel breathless or if your burning sensation in the lungs and throat is increasing, please contact a physician immediately.

Hope I have answered your query. If you have any follow up queries I will be available to answer them.

Above answer was peer-reviewed by
Follow-up: How is antihistamine toxicity treated ? 4 hours later
Without all of the histamines my body goes into anaphylaxis. My thyroid level is normal at 1.2 but my antibody levels are through the roof. My tpo is 1450 and my anti tpo is around 365...angiodema and throat closure happens when i don't take this level of antihistamine and then i have to be rushed to the hospital for a steroid shot and some epinephrine.Now I also have developed a fever of 103 so I am wondering if I really have the flu and the basement cleaning was just a coincidence.I am also coughing up dark yellow to XXXXXXX phlegm...Since I Just got off of prednisone about 4 days ago could my immune system still be weak enough to cause a bad cold? Two of my sisters have just recently tested positive for lupus and my doctor seemed to be concerned because my hives had been turning into XXXXXXX purple bruising and he biopsied and the result is a type of vasculitis that is why he is sending me to rheumatologist.They cant get me off the antihistamine without me going into anaphylaxis so they cant test for possible allergens. The hives have been going on for 3 years now. I had a nice year and a half of pretty minimal daily hives when they regulated my levothyroxin but they are saying my levels are still fine so now they are not sure if this is what caused it. We live in a very rural community in Vermont so getting necessary testing has been difficult. They say I am an enigma and do not know what my problem is. I finally recieved a referal to a bigger facility about 2 hours away. Would a fungal infection cause such a high fever?
Answered by Dr. Sumit Bhatti 21 hours later

Thank you for writing back again.

1. To reduce the side effects of antihistamines, I would recommend that you shift to newer generation antihistamines such as fexofenadine, levocetrizine or rupatadine.

2. Your elevated levels of anti-thyroid antibodies are consistent with Hashimoto's Thyroiditis. What is your TSH level?

3. Since you have high fever and phlegm, it should be treated as a chest infection with antibiotics and anti0fungal medication can be added if the fever does not abate.

4. High doses of steroids suppress the immune system and invasive fungal infection may lead to high grade fever.

5. You should have a full blood cell count (CBC), Erythrocyte Sedimentation Rate (ESR), C-reactive Protein (CRP), Serum Immunoglobulin levels (IgE, IgG), Anti Nuclear Antibody (ANA), XXXXXXX (Anti-Neutrophil Cytoplasmic Antibody), LE Cell Test, Liver Function Tests, Urine, ECG, Chest X-ray, Abdominal Ultrasound and FNAC (Fine Needle Aspiration Cytology) of the Thyroid Gland.

6. Though all these processes are allergic and autoimmune in nature, it is difficult to cover vasculitis / lupus and Hashimoto's Thyroiditis under the same umbrella. Though raised antibody levels indicate the level of activity of the disease, thyroid function tests are notoriously difficult to interpret and there is always a possibility that there may be some other autoimmune pathology present in your thyroid.

7. It is time for you to approach a regional tertiary reference center or facility for the above-mentioned tests.

Hope this helps answer your queries. I wish to know the results of the tests. Kindly post the reports of the test. And if you have any more additional queries, I will be glad to answer them too.

Above answer was peer-reviewed by
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