Expert: Marc Rubin, RPh Asthma Educator - 11/12/2008

Question
My son (3.5 years) has been diagnosed with Reactive Airway Disease. They cannot seem to find a cause and he takes a preventative medication but does not have a need for a rescue inhaler. He can run and play all day long but when he starts to get a cold or other illness he becomes severely congested and begind to wheeze, usually within 24 hrs of the onset of the illness. In July we lost our second son. He had a congenital birth defect and was taken early because he showed signs of heart failure due to c-cam. (congenital cystic adenomatoid malformation of the lung) My question is could it be possible that my older son has a less serious case of the same thing? I know this may not be in your expertise but you were the closest. I apologize if I've wasted your time.

Answer
Hi Andi,

This is out of my area of expertise, but I did a bit of research.

First, RAD has numerous triggers, but they are very individualized. Some cases are exercise induced, some have pollen or mold allergies which trigger attacks. But one thing all the patients have in common is a rapid increase in inflammation from viral infections, as well as Mycoplasma pneumonia and Chlamydia pneumonia. This is most likely the case with your son.

In C-CAD, the shortness of breath and wheezing is due to air-trapping in the lungs, something I believe would be notable on chest x-ray. Has the physician done an ultrasound exam? Although this condition is rare, many that occur are being seen on prenatal ultrasounds. In addition, if you physician has the ability to do an "exhaled nitric oxide" test...would be a good determination of the increase in inflammation pointing to, although not diagnosing, RAD. Unfortunately, at this early age, a spirometric test cannot be done to evaluate reversibility. Another test would be checking your sons' eosinophil level during a flare-up. This is a blood test which is a good indicator of an allergy induced attack.

I hope this helps you.

Sincerely,

Marc