Your symptoms — chronic cough for months, wheezing, chest tightness, night-time cough, watery mucus, and worsening with cold air and dust — along with a very high Serum IgE (>2500) are strongly suggestive of Allergic Asthma with Allergic Rhinitis.
This is not an infection and not a heart problem.
It is an allergy-driven airway inflammation, which explains why it keeps recurring and worsens at night and in cold weather.
High IgE indicates your immune system is over-reacting to allergens (dust, cold air, pollution, mites).
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Most Likely Diagnosis
• Allergic (IgE-mediated) Asthma
• Associated Allergic Rhinitis / Post-nasal drip
This condition is chronic but very well controllable with proper treatment.
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Recommended Treatment (Standard & Effective)
1. Inhaler Therapy (Main Treatment)
You will need a daily controller inhaler, not just cough syrup.
• ICS + LABA inhaler (example: Budesonide/Formoterol or equivalent)
→ Taken daily, even when you feel better
This reduces airway inflammation and prevents attacks.
2. Allergy Control
• Non-sedating antihistamine once daily
• Montelukast (especially helpful with high IgE and night symptoms)
3. Nasal Treatment (Very Important)
• Steroid nasal spray daily for allergic rhinitis
This reduces post-nasal drip and night cough.
4. Reliever Inhaler
• Short-acting bronchodilator only when needed for tightness/wheezing
Next Steps
Further Evaluation Needed
• Spirometry (PFT) to assess asthma severity
• Absolute eosinophil count (if not already done)
• If symptoms are severe or uncontrolled → allergy specialist review
With IgE this high, early proper control is essential to prevent long-term airway damage.
Health Tips
What to Avoid
• Dust exposure, cold air directly on face
• Room fresheners, incense, smoke
• Self-medicating with repeated antibiotics or cough syrups (they won’t help)