Managing Medication Allergies in Children with Favism: A Parent's Guide

To Pediatrician Dr. Hong

Hello Dr.
Hong,
My 10-year-old son has G6PD deficiency and has a history of medication allergies.
He frequently suffers from upper respiratory infections, and local clinics have run out of medications suitable for him.
The doctor recommended that we seek treatment at Yaomin Hospital in Caotun.
Initially, things went well, but gradually, allergic reactions started to reappear.
Recently, he caught the flu, and when we went to Yaomin Hospital in the afternoon to get medication, the doctor reviewed his list of allergy-inducing medications and informed me that he might be allergic even to the most common drugs, leaving only plain water as an option.
However, my son has been running a fever of 38 to 39 degrees Celsius, and I am genuinely worried about not giving him any medication.
In the end, the doctor prescribed a medication that he had taken before without any allergic reactions.
After taking one dose at home, he developed several small red spots on his forehead and some red patches on his scalp within an hour.
We returned to the doctor that night to change his medication, and they added an antihistamine.
He took one dose at 9 PM, and due to a high fever throughout the night, he took another dose after a little past 1 AM.
By the next day, his fever had not subsided, and his nose was red and swollen.
We went back to the outpatient clinic, where the doctor administered an antihistamine injection, changed his medication, and suggested that we should seek care at a teaching hospital.
After returning home and taking another dose, his forehead became severely swollen, and I hesitated to give him any more medication.
Given this situation, what should we do, Dr.
Hong? Is there really no medication he can take?
Sincerely, a worried mother.

Nantou High School Student Council Activity Group Yu Chen, 20~29 year old female. Ask Date: 2002/01/22

Dr. Hong Shaohui reply Pediatrics

In the short term, aside from antipyretics, there are other methods to help reduce fever, such as increasing fluid intake and taking lukewarm sponge baths.
In the long term, drug allergies are primarily a matter of individual constitution; however, if the allergic reactions are quite severe, it may be necessary to seek assistance from a pediatric immunologist.
PS: Due to Dr.
Hong Shao-Hui being on medical leave, the response is provided by the attending pediatrician, Dr.
Hsieh Tsung-Ta.

Reply Date: 2002/01/22

More Info

Managing medication allergies in children, particularly those with conditions like Favism, can be a daunting task for parents. Favism, a genetic disorder characterized by a deficiency of the enzyme glucose-6-phosphate dehydrogenase (G6PD), can lead to hemolytic anemia when exposed to certain triggers, including specific medications and foods. Given your child's history of medication allergies and recent respiratory infections, it is crucial to approach treatment with caution and a well-informed strategy.

Understanding Medication Allergies
Medication allergies can manifest in various ways, including skin rashes, hives, swelling, and in severe cases, anaphylaxis. In children with Favism, the challenge is compounded by the need to avoid not only certain medications but also foods that can trigger hemolysis. Common medications that may cause allergic reactions include antibiotics (like penicillin), non-steroidal anti-inflammatory drugs (NSAIDs), and certain antipyretics.

Steps to Manage Medication Allergies
1. Maintain a Comprehensive Allergy List: Keep an updated list of all medications your child is allergic to, including the specific reactions they experienced. This list should be shared with all healthcare providers, including emergency room staff, pediatricians, and specialists.

2. Consult with Specialists: Given the complexity of your child's condition, it may be beneficial to consult a pediatric allergist or a hematologist who specializes in G6PD deficiency. These specialists can provide tailored advice on safe medications and alternative treatments.

3. Explore Safe Medication Options: If your child has a history of reacting to common medications, discuss with the doctor about alternatives that are less likely to cause allergic reactions. For instance, acetaminophen (Tylenol) is often safer than NSAIDs for children with certain allergies, but this should be confirmed with a healthcare provider.

4. Monitor Symptoms Closely: After administering any new medication, monitor your child for any signs of an allergic reaction. If you notice any unusual symptoms, such as rashes or swelling, contact your healthcare provider immediately.

5. Educate Your Child: As your child grows, it is important to educate them about their condition and the importance of avoiding certain medications. This knowledge can empower them to communicate their allergies to caregivers and healthcare providers.

6. Consider Non-Pharmacological Treatments: For managing fever and discomfort, consider non-medication approaches such as cool baths, hydration, and rest. These methods can help alleviate symptoms without the risk of triggering an allergic reaction.

7. Emergency Plan: Have an emergency plan in place. This includes knowing when to seek immediate medical attention and having access to emergency medications, such as antihistamines or an epinephrine auto-injector, if prescribed.

8. Seek Second Opinions: If you feel uncertain about the treatment plan or the medications prescribed, do not hesitate to seek a second opinion from another pediatrician or specialist.

Conclusion
Managing medication allergies in children with Favism requires a proactive and informed approach. By maintaining clear communication with healthcare providers, exploring safe medication alternatives, and closely monitoring your child's reactions, you can help ensure their health and safety. It is understandable to feel overwhelmed, but with the right support and resources, you can navigate this challenging situation effectively. Always prioritize your child's well-being and do not hesitate to advocate for their health needs.

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