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I'm Writing For My Son. He Was Born At 36

Posted on Tue, 14 Jan 2020

Question: I'm writing for my son. He was born at 36 weeks, with no complications at birth. Despite some initial low APGAR scores, he was fine. He was a sickly baby/toddler/kid with recurring infections that required antibiotics. When he was 1, he had bronchitis twice, then pneumonia back to back to back. He has had two ear tube surgeries and another to remove his adenoids. That seemed to "cure" him for awhile but his health has gone worse again this year. He has had two ear infections, strep and an upper respiratory infection with wheezing that doctors think might have been pneumonia but never sent him for an XRAY. We have been referred to an allergist, where we discovered that he had all the allergies listed and he has started allergy shots. He had his immune system tested (IgG, IgA, IgM) and all came back normal. The only thing that was out of range was his red blood cell count which was too high. Is this a normal thing that doctors wouldn't be concerned about or is it something that requires more testing possibly. While I am overjoyed that his immune system does work, I'm not satisfied to believe that a kid who has been on antibiotics 5 times in a year is a normal thing. He has 3 other siblings who share the same house, space, food and toys and the other siblings haven't been sick in 2 years. Please let me know if I need a second opinion or more testing for himMy son is 9 years old. Weighs 65 pounds. Takes Zyrtec and Flonase. Just began allergy shots. Takes Benadryl at night as needed. No smoking, not a smoking house.
Previous medical issues: recurrent upper respiratory infections (ear infections, strep, bronchitis, pneumonia), fall/spring/dust mite allergies, recurrent cough and wheezing (possible asthma but not diagnosed), recurrent bouts of itching/hives that can be managed through Benadryl.

Answered by Dr. Dr. Pradeep Kumar Jain (1 hour later)

Brief Answer:
Appears to be allergic disorder, High RBC can be secondary to Recurrent RTI

Detailed Answer:
Hi

Thanks for asking on this platform

I have gone through the details and do understand your concern.
Coming to your queries one by one
Weight of 65 pounds at 9 years is within normal limit as per growth chart.
Raised RBC count in such cases in secondary to low level of oxygen due to repeated respiratory problems. High RBC count is commonly seen in patients of asthma. And I won't get worried if other physical findings (apart from respiratory one) and blood counts are normal.
I am not sure but may be he is getting over treated if we think about antibiotics. It's quite common for practioner to prescribe antibiotics for any kind of respiratory illness be it viral, bacterial or allergic.
Proper workup for bacterial infection should be done and antibiotics should be given only if results are positive or there is high clinical suspicion.
Its good to know that immune profile for IgA, IgM and IgG is normal as this rules out various immunodeficiency condition which can lead to bacterial infections. Here I would like to know if IgE level has been done or not. As serum IgE level gives a clue towards allergic origin of respiratory illnesses.
The immune system and response of body to allergens depends on individual. Although it runs in family but not always. So if other three siblings are normal then it's good that they are not sensitive to allergens.
I won't get overly worried as I think the treatment is on right track. Continue the antiallergic medication with inhaler and try to avoid the allergens. It has been seen in various studies that as the child grows the frequency of illness decreases if properly treated.
I hope this helps.
Please let me know if you have any more questions.
Wishing for good health of your family.
Thanks and regards

Above answer was peer-reviewed by : Dr. Prasad

Answered by Dr. Dr. Pradeep Kumar Jain (50 minutes later)

Brief Answer:
Thanks for appreciation

Detailed Answer:
Hi
Thanks for appreciation. Please feel free to ask if you have any more doubts. I shall be glad to help you out.
Thanks and Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Dr. Pradeep Kumar Jain (18 minutes later)

This is an amazing response. Thank you so much for the detailed explanation. That is exactly what I was looking for. Thanks again!