ABSTRACT

An 18-year-old man with allergic rhinitis complains of exercise-induced breathlessness and cough, one half hour following exercise. He denies respiratory symptoms at night or on other occasions, except when he is exposed to a cat. His forced expiratory volume in one second (FEV1) was 88% of the predicted value and chest radiograph was normal. He was prescribed a short-acting β2-agonist (SABA) to be used 15 minutes before exercise, and this reduced his exercise-induced respiratory symptoms, but he continued to require this treatment before each exercise session. Allergy skin-prick tests revealed sensitization to animal dander and tree pollen. He had no pets at home. His physician recommended he use a low dose of inhaled corticosteroid (ICS) daily. After 1 month, his FEV1 improved to 96%, and he rarely required his SABA before exercise, unless he trained intensely in cold weather. His symptoms of exercise-induced rhinitis were also controlled with a nasal corticosteroid.