Allergic rhinitis during ...

A 20-year-old pregnant female in her 8th week of gestation visited the clinic. She had a
medical history of allergic rhinitis and asthma and had several complaints during her first
visit. A month prior, she rescued a stray cat, and as a result, she experienced increased runny
nose, sneezing, stuffiness, and watery eyes. She also had difficulty breathing, wheezing, and
coughing, which woke her up at night, and she was concerned about taking her asthma
medications during pregnancy. Although she has had asthma since childhood, she has never
been hospitalized for it, except for a short course of oral corticosteroids about a year ago. Her
asthma symptoms are triggered by cleaning her house, upper respiratory infections, and
exposure to tobacco smoke. She has one cat at home and has never been evaluated for
allergies, although she has no history of food allergies or eczema. The patient had scattered
end-expiratory wheezing and boggy, pale, inferior turbinates bilaterally during her physical
examination. Spirometry showed an FEV1 of 77% of predicted, which increased to 90% after
receiving inhaled albuterol. In vitro, allergy testing demonstrated a specific IgE level of >100
kUA/L for dust mites and cat dander.