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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Underweight, Allergies, Asthma, Sickness, Getting Worse. Are They Infections?

My son, age 6, has always been a finicky eater and until recently, on the verge of underweight. He's almost always had dark circles under his eyes. He has been diagnosed with allergies and asthma, both of which are being managed. But he is also always very pale, which is not something I would consider hereditary. His father is Polish, therefore fairly dark complected. I have a lot of Cherokee ancestery myself and am not exactly fair skinned. He's been 'sickly' since entering the world, seeming to have a low immune system, but the doctors brush me off and say he's fine. NOW, since February of this year, he has had two seizures. He has an appointment with a Neurologist, but not until July of this year. The symptoms may all be totally unrelated, but he just doesn't seem like a normal, healthy 6 year old little boy. Anything in particular I should be looking for or checking up on as far as diseases, syndroms, infections, or just any specific conditions I haven't mentioned we've already addressed that sound like they could be of concern?
Mon, 6 May 2013
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Allergist and Immunologist 's  Response
Hello,

To put all the problems in perspective: Your son aged 6, has allergies and asthma, but also pale and gets recurrent infections having now had epilepsy and waiting to see a neurolgist.

Blood tests that will be helpful include:
Complete blood count - Hb if low, requires treatment especially if iron deficiency anaemia (pale with dark circles under eyes)
Liver function tests
IgE levels
Specific IgE tests against aeroallergen panel (foods as well, if indicated)
Thyroid function tests
IgG, IgA, IgM - to know if antibody levels are normal

He will need an EEG and/or MRI Brain at some point depending what the Neurologist feels.
Do not go into syndromic diagnosis at this point unless the investigations point in this direction.
I hope all his immunizations are up to date.

Try and broaden his diet to increase his weight, with protein drinks and ensure his asthma is well under control. Inhaled steroids (high doses) or oral steroids for asthma can increase susceptibility to infections, so ensure that this is not the case.

I hope that was useful.
Best Wishes.
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Underweight, Allergies, Asthma, Sickness, Getting Worse. Are They Infections?

Hello, To put all the problems in perspective: Your son aged 6, has allergies and asthma, but also pale and gets recurrent infections having now had epilepsy and waiting to see a neurolgist. Blood tests that will be helpful include: Complete blood count - Hb if low, requires treatment especially if iron deficiency anaemia (pale with dark circles under eyes) Liver function tests IgE levels Specific IgE tests against aeroallergen panel (foods as well, if indicated) Thyroid function tests IgG, IgA, IgM - to know if antibody levels are normal He will need an EEG and/or MRI Brain at some point depending what the Neurologist feels. Do not go into syndromic diagnosis at this point unless the investigations point in this direction. I hope all his immunizations are up to date. Try and broaden his diet to increase his weight, with protein drinks and ensure his asthma is well under control. Inhaled steroids (high doses) or oral steroids for asthma can increase susceptibility to infections, so ensure that this is not the case. I hope that was useful. Best Wishes.