[26F] Experiencing Hives, Muscle Pain, Shaking, and Fainting Episodes

Patient Description

A 26-year-old female has been experiencing a complex set of symptoms for several years, including thick red hives that are extremely itchy but painful to touch, appearing randomly all over her body for the past 5 years. Accompanying the hives, she reports aching muscle pain rated 6/10 in severity, noticeable whole-body shakes preceding hives outbreaks, slight shortness of breath, facial and lip swelling, lightheadedness, and occasional fainting episodes with tunnel vision for the past 12 years. The muscle pain and shakes are closely associated with the hives and subside a few hours after the hives dissipate. She has a history of asthma, which is rarely an issue in her adult years, and is not currently on any medications. The symptoms significantly impact her quality of life, yet no specific triggers have been identified.

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Arora's Assessment

What might be happening

Based on the information you've provided, you may be experiencing:

  • Chronic Urticaria: This is a condition where hives or welts appear on the skin, last for more than six weeks, and often come and go. The hives are usually accompanied by itching. The exact cause of chronic urticaria is often difficult to identify.

    • Treatment typically involves antihistamines to control the itching.
  • Anaphylaxis: This is a severe, potentially life-threatening allergic reaction that can occur rapidly. Symptoms can include hives, swelling of the face or lips, shortness of breath, and fainting. Given your history of asthma, you may be at a higher risk for anaphylaxis.

    • Treatment involves immediate medical care, usually with an injection of epinephrine.
  • Vasovagal Syncope: This is a condition that leads to fainting as a result of a sudden drop in heart rate and blood pressure, leading to reduced blood flow to the brain. It's often triggered by certain stimuli, like the sight of blood or extreme emotional distress.

    • Treatment usually involves avoiding known triggers and certain physical maneuvers that can help prevent fainting spells.

What you can do

  1. Seek immediate medical attention if you believe you are experiencing anaphylaxis, as this is a medical emergency.
  2. Schedule an appointment with your healthcare provider to discuss these symptoms further. They may refer you to a specialist, like an allergist or immunologist, for further testing.
  3. Keep a symptom diary. Note when your symptoms occur, how long they last, and any potential triggers. This can help your healthcare provider in making a diagnosis.

What you should look out for

  • If you experience difficulty breathing, chest pain, or a feeling of impending doom, seek immediate medical attention.
  • If your symptoms worsen or if you notice a pattern to when they occur, make note of this and discuss it with your healthcare provider.
  • If you faint and do not regain consciousness quickly, or if your fainting is accompanied by other severe symptoms, seek immediate medical attention.

Please note that while I strive to provide accurate and helpful health information, I am an AI and not a doctor. Always consult with a healthcare provider for a formal diagnosis and treatment.

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1 yr ago

People Also Ask


What are the common causes of chronic urticaria?

Chronic urticaria can be caused by a variety of factors, including autoimmune disorders, infections, stress, and certain foods or medications. However, in many cases, the exact cause remains unknown.


How can I differentiate between a mild allergic reaction and anaphylaxis?

Anaphylaxis is characterized by severe symptoms such as difficulty breathing, swelling of the face or lips, and a rapid drop in blood pressure, which can lead to fainting. Mild allergic reactions may involve localized hives and itching without these severe symptoms. Anaphylaxis requires immediate medical attention.


What are some strategies to prevent vasovagal syncope episodes?

To prevent vasovagal syncope, it's important to identify and avoid known triggers, stay hydrated, and practice physical maneuvers like crossing your legs or tensing your muscles when you feel faint. Lying down and elevating your legs can also help if you feel an episode coming on.


How can keeping a symptom diary help in diagnosing my condition?

A symptom diary can help identify patterns or triggers associated with your symptoms. By recording when symptoms occur, their duration, and any potential triggers, you provide valuable information that can assist healthcare providers in diagnosing and managing your condition more effectively.


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