House dust mite respiratory allergy is an allergy cause by house dust mites found in your home which is a core source of indoor allergen. House dust mites can cause respiratory diseases namely Allergic Rhinitis and Allergic Asthma. Both of which can have significant impact on quality of life and can be costly if left untreated. House dust mite are sensitized in about 70% in Thai people and can cause serious diseases. People with symptoms and such diseases are advised to screen for allergies they are sensitized to and confirm diagnosis by allergy specialist doctor in conjunction with medical history evaluation.

The two major species of house dust mites are Dermatophagoides pteronyssinus and Dermatophagoides farinae. Dust mites are adapted to live in similar living conditions to humans and are capable of fast reproduction, and while regular cleaning may help to reduce the concentration of mite in the home, it may be impossible to completely ‘eliminate’ mites from a household. They thrive on humid and warm mattresses, beddings, carpets, curtains, and furry surfaces. Current guideline recommends treatment to control symptoms and if possible use allergen immunotherapy to train body not to be allergic to house dust mites and have a chance to be cured.

Symptoms

House dust mite can cause both upper and lower airway diseases, which are allergic rhinitis and allergic asthma respectively. Allergic rhinitis is linked to development of allergic asthma if left untreated. The two diseases are commonly known as one airway one disease.

Allergic Rhinitis

• Runny and blocked nose

• Itching

• Sneezing

Allergic Asthma

• Difficulty breathing

• Wheezing

• Coughing

Treatment

Treatment is usually symptomatic for allergic rhinitis and controlling asthma symptoms however for patients with moderate or severe diseases with recurrence of symptoms, allergen immunotherapy can treat the root cause of house dust mite allergy in which the long-term medication for both allergic rhinitis and allergic asthma can be reduced.

Allergic Rhinitis

• Antihistamine oral and/or intranasal

• Intranasal corticosteroids

• Oral steroid as needed

• Surgery as indicated by an ENT doctor

Allergic Asthma

• Inhaled corticosteroids and Bronchodilators

• Oral steroid as needed

• Biologic agent for severe asthma

• Other medications such as leukotriene antagonist and PDE4-inhibitor

Allergen Immunotherapy 

• House dust mite sublingual immunotherapy tablet (SLIT) taken once daily as fast dissolving tablet under the tongue for 3 years. Studies have shown reduction of symptoms for allergic rhinitis as soon as 8-12 weeks and significant reduction of asthma attacks (exacerbations)

• Subcutaneous immunotherapy requiring multiple weekly buildups during first 6 months and adjustment as needed, then administer subcutaneous injection once a month to complete 3-5 years course

• The goal of allergen immunotherapy is to cure house dust mite allergy and reduce medication needed to resolve symptoms and reduce level of symptoms to increase quality of life

When to contact a doctor

For persistent symptoms of allergic rhinitis or currently taking asthma medication for allergic asthma, consult your ENT or allergy specialist doctor to correctly diagnose the driver of your allergy. Treating allergic rhinitis early can prevent risk of developing into allergic asthma.