Respiratory Disorders Expert Forum
Recurrent Croup
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Recurrent Croup

My four-year-old son has had croup off and on since he was around 10 months old. It has resulted in stridor about four or five times, but because his symptoms usually progress in the same manner, we are able to treat him more aggressively now. (The symptoms prior to cough are usually consistent -- it starts with a runny nose, then post nasal drip, then either a dry or wet cough, then the croup sets in.)

Still, since August 2008, he has had at least eight bouts with croup and has been on dexamethasone three times, pednisone five times. My son has had an larynoscopy, bronchoscopy and allergy tests. These have been evaluated by an ENT, GI specialist and two different allergy/asthma specialists at the University of Iowa Hospitals and Clinics, all to no avail. (He was also diagnosed with acid reflux and put on 60 mg of Prevacid per day, but thus far, Prevacid seems to have not helped at all.) They can tell us how to treat the croup with different meds, but not how to prevent it.

We have tried preventative meds in the past -- albuterol and pulmicort primarily. We also tried treating the nasal-congestion part of the problem with Veramyst and Nasonext, but these just made the cough "wetter" and more frequent, leading right back to the croup eventually.

The problem with all of this is that the frequency of these bouts has increased, while the duration of time between the bouts has decreased. We are looking at having our son on some sort of steroid to treat this at least three times a month now. It seems as though as soon as the steroids wear off, the cough comes back. It is very, very difficult to lead a normal life when constantly having to monitor and treat this disease. And, of course, we are very worried about the long-term effects of this type of steroid treatment.

Can anyone tell me if they've had this experience and how they dealt with it? Is there a clinic or hospital here in the U.S. known for treating this sort of croup, or unusual forms of asthma?

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It is clear that your son has been evaluated by some fine doctors, at the University of Iowa Hospitals.  His is a most difficult problem and I would ask that you consider seeking a second opinion.  If traveling to Denver, Colorado is feasible for you, National Jewish Health would be the ideal place for your son to come for a thorough evaluation.
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