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What Causes Eosinophilia, Dry Cough And Blocked Nose?

Posted on Fri, 18 Mar 2016

Question: Hi,

I have usually high eisnophil count >10% many times in a year, often followed by blocked nose and dry cough. I had done an x-Ray long time back, and it showed normal, except for pulmonary infiltrate, kindly advise.

Answered by Dr. Drkaushal85 (1 hour later)

Brief Answer:
Get done repeat chest x ray and PFT.

Detailed Answer:
Thanks for your question on Health Care Magic.
I can understand your concern.
You are having eosinophilia with cough and blocked nose.
So possibility of allergic disease like allergic rhinitis and asthma is more.
You also had Pulmonary infiltrate. So we should also rule out ABPA (Allergic bronchopulmonary aspergillosis).
So get done fresh chest x ray and PFT (Pulmonary Function Test).
Please let me know
1. Do you have expectoration?
2. Do you have wheezing?
3. Have you ever undergone serum IgE level?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (4 minutes later)

I have trouble breathing sometimes, I had a serum IgE test a year back, and they were elevated beyond the normal range.

The PFT test was normal

Answered by Dr. Drkaushal85 (5 minutes later)

Brief Answer:
Have you ever undergone CT thorax?

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
So you had elevated IgE with breathing problems intermittently.
Please let me know
1. Have you ever undergone CT thorax?
2. What was doctor's opinion at the time of pulmonary infiltrate?
Please reply me answers of above asked questions, so that I can guide you better.
I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (4 minutes later)

No not done a CT thorax, the doctor did not provide any input on the xray, as the PFT was normal, and there was no wheezing or signs of asthma.

Also recently i have developed alopecia of the beard, which doctor advised me is some auto-immune disorder.

Answered by Dr. Drkaushal85 (11 minutes later)

Brief Answer:
Which drugs you are taking at present?

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern
Alopecia is having many causes. And auto immune disease can also cause alopecia.
Please let me know
1. Which drugs you are taking for blocked nose and dry cough?
2. Have you investigated for auto immune diseases? Have you undergone ANA (anti nutrophilic antibodies) test?
3. Do you have family history of allergy or auto immune disease?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (3 minutes later)

1. No drugs at the moment
2. Not investigated the auto immune disease, no one advised me on this particular test
3. My mother gets frequent cough and cold as well, due to dust or pollution allergies

Answered by Dr. Drkaushal85 (6 minutes later)

Brief Answer:
Do you other auto immune disease symptoms?

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
In my opinion, your blocked nose and cough are mostly due to allergy and these are not associated with alopecia.
Please let me know
1. Do you have other auto immune disease symptoms like joint pain, skin rashes, dryness of mouth etc?
2. Do you have dust or other allergies? Do your symptoms worsen in dusty environment? Do you have seasonal variation in symptoms?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (3 minutes later)

1. No other symptoms are present
2. Yes in dusty environment, symptoms get worse, often followed by frequent sneezing

Answered by Dr. Drkaushal85 (5 minutes later)

Brief Answer:
No need to worry for auto immune diseases.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
Since you are not having other symptoms, no need to worry for auto immune diseases because auto immune disease is extremely rare in males and rare without constitutional symptoms.
Your nose blockage and cough are mostly allergic.
This also explains high eosinophil count and elevated IgE.
You first get done chest x ray and PFT.
Chest x ray is needed to compare Pulmonary infiltrate whether increasing or stable or decreasing.
PFT is must to rule out asthma.
You may need intranasal spray containing steroid and inhaled treatment.
Please let me know
1. Do you have more cough at night?
2. Have you ever tried intranasal spray containing steroid?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (6 minutes later)

Okay will get xray and pft done.

1. Yes sometimes it is more at night.
2. Never tried intranasal spray, only used otrivin, but it never helped, made it worse sometimes.

Answered by Dr. Drkaushal85 (4 minutes later)

Brief Answer:
Don't use otrivin.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
You will definitely improve with intranasal spray containing steroid (fluticasone).
For dry cough inhaled corticosteroid (budesonide) will work.
Oral combination of antihistamine and anti allergic drugs is also beneficial in your case.
Please let me know
1. Since how long you are having these symptoms?
Is it since childhood?
2. Have you tried anti allergy drugs?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (4 minutes later)

1. Yes used to get cough and blocked nose, atleast 2-3 times a year since childhood, however this has progressed to slight breathlesnes over a period of time as i grew up
2. Not tried any anti-allergy drugs at the moment

Answered by Dr. Drkaushal85 (4 minutes later)

Brief Answer:
You will definitely improve with anti allergy treatment.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
I am almost sure about allergic disease in you.
But better to get done chest x ray for Pulmonary infiltrate.
You will definitely improve with intranasal spray containing steroid (fluticasone), oral combination of antihistamine and anti allergic drugs and inhaled corticosteroid (budesonide).
Hope I have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar. I would love to hear your progress.
Wish you good health. Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (2 minutes later)

Thank you for your help, any suggestion on what kind of anti-allergic drugs

Answered by Dr. Drkaushal85 (2 minutes later)

Brief Answer:
Combination of antihistamine and anti allergic drugs.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
Combination of antihistamine (levocetrizine or fexofenadine) and anti allergic drug (montelukast) is available in the market.
Intranasal spray containing fluticasone and budesonide inhaler are also considered as anti allergic drugs.
Please let me know where are you living, so that I can tell you brand names of these drugs.
I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (0 minute later)

I am currently in abu dhabi

Answered by Dr. Drkaushal85 (4 minutes later)

Brief Answer:
Here are brand names.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
Here are brand names for levocetrizine and montelukast combination.
1. Allegra M
2. Montek LC
3. Montair LC
4. Torkast FX.
Brand name for fluticasone nasal spray.
1. Foramist
2. Fluticon
3. Allermist etc.
Brand name for budesonide inhaler.
1. Budate
2. Budecort
Please let me know your weight and height, so that I can tell you dose and frequency and time of taking these drugs.
I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (1 minute later)

Okay
Weight 78 kgs
Height 171 cms

Answered by Dr. Drkaushal85 (3 minutes later)

Brief Answer:
Take drugs as follows.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
Take drugs as follows.
Take combination of levocetrizine or fexofenadine and montelukast 1 tablet at night time. Dose of levocetrizine is 5 mg, fexofenadine is 180 mg and Montelukast is 10 mg.
Take fluticasone nasal spray two puffs in each nostril twice daily. (morning and night).
Take budesonide inhaler (200 micrograms) one puff twice daily (morning and night).
Hope I have solved your query. If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar. Wish you good health. I would love to hear your progress. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (1 minute later)

Okay thanks a lot

Answered by Dr. Drkaushal85 (2 minutes later)

Brief Answer:
Please close the conversation and rate my answer.

Detailed Answer:
Thanks for your question on Health Care Magic.
If you are not having further queries, then please close the conversation and rate my answer.
It's always encouraging for doctors to hear positive feedback from patients. I am glad that my advise is helpful to you.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wish you good health. Thanks. Do let me know your progess.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar