Allergy is a very complicated condition and is still not .understood completely. The signs and symptoms are often related to the type of allergy and at times may be vague and hard to believe. Each type of allergy is explained with the help of case studies.
Whenever there were rains, Sania would start sneezing uncontrollably on waking up in the morning. Her eyes and nose would start watering incessantly and would become reddish and sore. By evening she would complain of itching in the throat and by next morning there would be severe cough and even fever. When Sania consulted a doctor, he informed her that she was suffering from Dust Allergy and this would usually be aggravated during humid weather conditions.
Thus from the above case-study, the signs and symptoms of dust allergy are well evident. Besides the above symptoms, some people complain of itching in the eyes, nose and ears which are very significant for dust allergy. Headache, bodyache, malaise, fatigue and irritability is sometimes present. When dust allergy affects the lungs, it is known as Allergic Asthma. In this condition the common symptoms are difficulty in breathing, wheezing or whistling sounds heard while breathing, coughing with sputum formation and a feeling of tightness in the chest. Some of these individuals may also have signs of skin allergy and may be allergic to aspirin.
In the USA, food allergy occurs in 6-8% of children and 1-2% of adults. About 15% of the general population believe that they may be allergic to some food. Majority of food-allergic reactions present in the first year of life.
Mrs. Batra noticed that whenever they gave a treat of Cheese Pizza and Chocolate Ice-Cream to Rohan, he complained of stomach-ache and headache and was very irritable and tired for about 24-48 hours. When they consulted a gastroenterologist, he suggested that cheese and chocolate could be the culprits. Rohan was diagnosed as a case of food allergy.
The most important aspect of food allergy is to remember that the signs and symptoms are not localised to the digestive system, but may occur in other parts of the body too. Some people with food allergy may develop itching and swelling around the lips and tongue after consuming melons, bananas, carrots, celery, apples, hazelnuts and raw potatoes. These symptoms may often be very mild and undetected and may resolve without any medicines.
Others may develop nausea, vomiting, stomach-ache or cramps and diarrhoea within a few minutes to two hours after eating the allergic food items. Itching in the eyes, redness and watering may be seen in some. Some people have attacks of sneezing, running nose, coughing, hoarseness of voice, breathlessness and cough. Skin allergy is a very common effect of food allergy commonly seen with fish, nuts and peanuts. In very few individuals, food allergy may be fatal leading to weakness, low blood pressure and collapse.
Allergy to medicines varies according to the medicine given, the route by which given (oral or injections), dose and allergic susceptibility of the individual. Signs and symptoms of a few medicines are given below.
Allergy to insulin injection is often seen as a mild itching, swelling and pain at the site of injection which may subside within an hour of injection. In some, the allergy may be severe with itching all over the body and increase in the swelling, and pain persisting for more than two weeks.
Important clues of latex allergy are itching or swelling around the mouth after dental check-up or after blowing up balloons, local swelling or itching after vaginal or rectal examination or after use of condoms or itching of hands after coming into contact with any substance made of latex.
Individuals with allergy to aspirin usually develop running nose, sneezing, redness of eyes, wheezing and cough resembling sinusitis or asthma. Some individuals may develop skin problems, hoarse voice, abdominal pain and low blood pressure. Allergy to other medicines, especially intravenous injections and anaesthetic agents are often fatal in allergic individuals and hence a test dose should be given before administering the injection.
When Meenakshi Subramaniam delivered her first baby boy, everyone was overjoyed. The boy was so cute that everyone from the neighbourhood came to see him when he reached home. Suddenly, the next morning, Meenakshi saw that there were many red rashes all over the baby’s face and body. She began to cry incessantly. Her husband immediately called the Child Specialist, Dr MK Sharma for his opinion. The doctor pacified them by saying that it was just insect allergy due to mosquito bites and they should use a mosquito net and repellant to protect the baby.
The normal reactions to insect bites and stings are itching, burning, pain, redness and mild swelling at the place of bite. In allergic individuals, the swelling continues to increase even after 6-8 hours and may involve a larger area with severe pain and redness. Some people have breathing problems, pain in the chest, cough, low blood pressure and may go into a state of shock. Children are less prone than adults to develop severe symptoms.
Rita was very happy when her husband presented her with a beautiful Titan watch for her birthday. She wore it to her office and everyone appreciated it. On returning home, she developed severe itching around her wrist. On removing the watch, she noticed that there was severe redness and swelling around her wrist. When she consulted a doctor, she came to know that it was a skin allergy due to the presence of nickel in the stainless steel strap.
Skin allergy, as described earlier, is of two types – Atopic Dermatitis and Contact Dermatitis.
In Atopic Dermatitis, there is severe itching and redness and the’ disease is chronic and relapses from time to time. In children less than two years, the disease may be seen on the face and outer aspect of knees and elbows. In children above two years of age and in adults, the inner folds of arms and knees are involved. The other associated features are presence of allergy in other family members, seen in young age, influenced by environmental or emotional factors, itching associated with sweating and intolerance to wools and other irritants.
In Contact Dermatitis, the exposed areas of the body, especially the hands and face are most frequently and at times exclusively involved. The thinner sites like the eyelids, earlobes and genital skin are most vulnerable while thicker skin like the palms of hands and soles of feet are more resistant. Eyelids are a common target for contact dermatitisbecause of frequent exposures, increased susceptibility to irritants and allergens and easy accessibility to rubbing. Eyelids are more commonly involved due to cosmetics applied to other areas of the body like nails and scalp than to cosmetics directly applied to the eye area. Similarly, sensitivity to nail polish often affects the neck rather than hand.
Allergy towards Pets
Mr. Arora realised that whenever he came to the bedroom, he developed sneezing and running nose. This did not happen when he was in the other rooms. When he contacted Dr Chawla, their Family Physician, he realised that it was due to the addition of a new member in their family – Lucy, the cute Pomeranian puppy. Mr Arora was suffering from allergy due to the pet animal. When Lucy was given a separate kennel outside their house, this problem disappeared.
Many people love to keep pets at home, but some of them may be suffering from allergy towards these animals. The symptoms associated with pet allergy usually include running nose, itching and watering of eyes, swollen eyelids, headache and sore-throat. For some people, an asthmatic attack may be triggered off when they are in close contact with their pet. They complain of tightness in the chest, shortness of breath, wheezing or whistling sounds in the chest and cough. This can sometimes be very serious and needs medical attention.
Some individual’s skin is allergic to the ultraviolet rays of the sun. In such people, an eczema-like rash in seen in sun-exposed areas such as the forearms, back of hands, front of the neck and face. These rashes are well-demarcated and totally absent in those parts of the body which are always covered with clothing.