Bright red cheeks!

[Stephyjane]

Hi,
I know this ones a bit strange, but the last couple of nights my daughter has gotten really hot red cheeks, she also has a slight sore throat that has been hanging around for about a week and feelings of nausea. There has been no temperature. The only thing different meds wise is an increase in dosage of her Azathioprine and introduction of Salofalk. She also has had a couple of very emotional episodes where she has been very upset and crying, not like her at all.
Just wondered if anyone has experienced this. Wasn't sure whether she is a bit under the weather or possible side effects from the medication.
Her hair is coming out a lot too.
Thanks xx

Mother to Ella aged 10 years, diagnosed June 2012
Current meds: 10mg prednisolone (halted taper)
75mg Azathioprine
15mg Lansoprazole
1g 3xaday Salofalk

 

[Farmwife]

Sorry no help here.
I hope she starts feeling like her old self soon.

 

[Twiggy930]

My son gets flushing of his cheeks sometimes. It happened a lot when he was on high doses of prednisone but it still occasionally happens. I think it might just be a Crohn's thing but I'm not sure.

 

[my little penguin]

AZA can cause flushing as a side effect - please et your GI know.

 

[AZMOM]

Agreed. Big changes that coincide with med changes (dosage or kind) warrant a call. Let us know....

J.

 

[jmckinley]

The meds can also cause hair loss. My son takes methotrexate now which causes hair loss. He also lost hair when he took 6mp which is similar to AZA if I'm not mistaken.

 

[Sascot]

Definately worth letting the GI know what's happening. My son is quite bad for getting hot/flushed cheeks but it never lasts more than a few hours. Sounds like it might the increase in meds. Hopefully it will settle down soon.

 

[Avw]

I used to get the hot flushed cheeks every single night for the first year or two after I was diagnosed, felt like my face was on fire from the inside. I still get them sometimes, and I am definitely not on the same medications now. I'm sure it can be caused/exacerbated by some medications, but I think it just the disease itself, especially since it only occurs during a flare for me. But still, definitely let your doctor know, and let us know if you find out anything! I'd be really interested to know what's causing this. Hope your little one feels better.

 

[DustyKat]

I agree with having it checked out. The cheek redness may well be a side effect of the meds but also with her being immunosuppressed I wonder if she has picked a bug. It wouldn't hurt for the doc to rule out something like slapped cheek (human parvovirus B19).

Hair loss isn't an uncommon side effect of Aza and usually resolves given time. My son certainly experienced it but to be honest, in his case, I personally believe the loss had as much to do with it being a reflection of his poor physical heath as it did with the meds.

Take care and keep us posted...:hug:
Dusty. xxx

 

[Stephyjane]

Thank you all for your replies.
I have spoken to Ella's drs secretary today and she says that after speaking to the dr he has checked her bloods from last week and nothing has jumped out at him. We are still waiting the results from the X-ray of her spine from over 2 weeks ago, and she is having more bloods done tomorrow.
I'm going to see if she gets her red face again this evening and speak to the dr tomorrow when we go in.
I'll let you know what happens.
Ella is starting a new year at school tomorrow and I'm quite worried about her catching bugs etc especially going into the Autumn, does anyone have any tips at keeping the bugs away, apart from sending her to school in a bubble :lol:

Thanks again :hug:

 

[Patricia56]

I suggest you take a couple pictures of her face to show the doctors. One that shows shoulders and head and at least one that's closer up that shows the reddened skin. If there's a distinct edge to the redness then be sure to get a picture of that area that shows both the normal colored skin and the reddened skin.

I would also get her tested for strep. Strep is a trickster and can show up in many different ways. Since she's immune suppressed there's a good chance she would not develop the typical symptoms of sore throat and fever.

My son had strep twice in one year and both times his only symptoms were a slight sore throat and some mild cold symptoms. But I insisted they test him with the in office quick test that first time and he tested positive. His doctor was surprised and sent it out for the lab to double check and it confirmed the diagnosis.

So from then on we checked him when he had cold symptoms and one other time he tested positive with almost no symptoms.

Finally, it might also be the prednisone, especially since you are also describing mood swings. She is probably (don't panic mom) prepubertal and already having some hormonal changes happening that, combined with the pred, are giving her the tearful episodes.

My medication "rule" is to avoid introducing more than one medication at a time or adjusting more than one medication at a time. That way, if there's a problem with the medication or the dosage you can be fairly sure which med/dose is the problem.

If she had the increase in AZA at the same time as adding the Salofalk, I would think about asking the doc if you could stop the Salofalk for now . 5ASA drugs (mesalamines) generally are not very effective in Crohn's unless she has a very mild case of colonic CD in which case she normally wouldn't be on AZA as far as I know.

That way you may be able to determine if it's a reaction to the AZA or something else.

Hope the mood swings stop. Those are so disruptive to a child's sense of well being. I think even more than the physical illness at times. Going to bathroom a lot is not nearly as obvious as breaking down in tears in front of all your friends.

 

[Twiggy930]

Just wanted to add that the 5ASA drugs can be prescribed to treat joint pain/inflammation. That is why some doctors will prescribe a 5ASA and azathioprine together. We tried Pentasa but have had better luck with Sulfasalazine. The 5ASA drugs can take upwards of a month to work so I would be hesitant to stop the drug if it is being used to treat your daughter's back pain.