Role of environmental control in the management of asthma and allergy

摘要

An 8-year-old boy and his mother are referred to an allergist by his pediatrician. He has asthma that is reasonably well controlled on daily moderate-dose inhaled corticosteroids in addition to symptoms consistent with persistent allergic rhinitis. His pediatrician and mother are both interested in having him evaluated for allergies that might be contributing to his asthma and allergic rhinitis. He has no nocturnal symptoms, and his last exercise-induced symptoms occurred 2 weeks ago. He typically needs rescue medication once every 1 to 2 weeks. He has never been hospitalized for his asthma, and his last emergency department visit was a year ago. He had 2 exacerbations in the past year requiring oral corticosteroid bursts, and this has been the typical frequency for his exacerbations over the past several years. His exacerbations tend to occur in the winter and fall, and the triggers are generally not clear to his mother. However, she reports that one of his exacerbations occurred after he spent the night with a friend who had 2 cats.