KLE Hon, TF Leung

Abstract

Many symptoms can be caused by allergies. A 5-year-old Chinese boy was referred to a private clinic with cervical lymphadenitis, severe epistaxis and atopic symptoms. On inquiry, he revealed a multitude of symptoms, including nasal stuffiness, sneezing, snoring, cough, and skin peeling of hands. Clinically all the symptoms could be explained by atopy. The mother was not keen for any investigations, and she was concerned with the usage of inhaled topical corticosteroids for rhinitis and hyperactive airway disease. The boy was empirically treated with 4 mg daily of Montelukast and all his symptoms resolved within 4 weeks. This report serves to alert the general public on the diversity of allergic symptoms and on the fact that undertreatment may lead to a spectrum of secondary symptoms. Montelukast may be considered as a monotherapy in such patient, which obviates the need to use multiple inhaled and oral treatments.