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No improvement with montelukast and livocitrizine for reduction of AEC count. What do you suggest?

DOCTOR OF THE MONTH - Apr 2014
Apr 2014
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I am 63 year old male ,My present AEC count is 1.90 thou/mm3.and IgE 449.00 KUA/L ,it remained almost same through out for last one year when first time I got it tested. My ENT had prescribed Xaria daily containing Montelukast and livocitrizine,for last one year and also the solspre and flixonase sprays twice daily and also the Efcorline drops but it has not helped.I had aso been given Hetrazone -100 three tab a day for almost 6 months but the levels had not come down except for a short while when my doctor prescribed Steroids for 4-5 days . Symptom wise I am not having any major problem except continuous Phlegm in my throat which is very annoying at night. I am B.P. and diabetic patient but remain normal with minimum dose 5 mg Neual and 500 Metformine a day. Iam daily walker for almost 5 km. and regularly doing Pranayama for half an hour every day. Please advise the repercussions of such high levels of AEC and how this can be treated
Posted Fri, 13 Dec 2013 in General Health
 
 
Answered by Dr. Indu Kumar 1 hour later
Brief Answer: Eosinophil will come down with control of allergen Detailed Answer: Hello XXXX Thanks for writing to XXXXXXX You are suffering from Eosinophilia.In your case it is due to allergy. There are also many other reasons for eosinophilia like autoimmune diseases, skin disorders etc. You have continuous throat infection and this is causing persistently increased eosinophil level in blood. You have been prescribed with maximum medicines. You are rightly given saline nasal drops,steroid inhaler,antihistaminic and leukotriene receptor antagonist (LTRA). Oral steroid can't be given for long time.Hetrazan tablets are also rightly given for eosinophilia. Allergic cause is confirmed by increased level of eosinophil and IgE.It depends on person immunity and susceptibility. We can only avoid if there is known allergen and can take above medicines already discussed. Don't worry about increased level of eosinophils.It will come down after control of irritant.Cause of allergy should be searched and need avoidance of allergen. You can consult immunologist also. You should take medicines regularly for other diseases also. Get well soon Hope i have answered your query. Further queries are most welcome. Take Care Dr.Indu XXXXXXX
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Follow-up: No improvement with montelukast and livocitrizine for reduction of AEC count. What do you suggest? 19 hours later
As the allergens are not known,How long the medicine should be taken , whether the long time medication have any bad effect or harm ?
 
 
Answered by Dr. Indu Kumar 1 hour later
Brief Answer: Take drug six weeks prior to the arrival of season Detailed Answer: Hello XXXX Thanks for writing back In many cases allergen is not known but in most of the cases it is seasonal allergy. You can take montelukast and levocetrizine combination tablets prophylactically for six weeks before the arrival of vulnerable season you suffer most. Absorption of nasal steroid spray in the body is very less so you can take it safely. Oral steroids has many side effects and it should be avoided. Get well soon. Hope i have answered your query. Further queries are most welcome. Take Care Dr.Indu XXXXXXX
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