[37F] Experiencing severe chronic urticaria with facial and lip swelling

Patient Description

A 37-year-old female reports suffering from severe chronic urticaria with hives that are itchy and present all over her body. She is currently taking 780 mg of Allegra daily to manage the symptoms. The patient has identified stress, high histamine foods, and the elastic on clothes as potential triggers for her hives. Additionally, she experiences swelling of the face and lips but does not have any respiratory symptoms such as difficulty breathing or throat swelling, nor any signs of anaphylaxis like difficulty swallowing, hoarseness, or wheezing. There are no reports of lightheadedness, chest tightness, or a rapid heartbeat. No other symptoms have been reported, and there is no mention of a family history of related conditions.

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Arora's Assessment

What might be happening

Based on your symptoms and the information provided, the following conditions could be considered:

  • Chronic Urticaria: This is a condition where hives or wheals appear on the skin, last for more than six weeks, and often recur over months or years. It's often associated with severe itchiness. The exact cause is often difficult to identify, but triggers can include stress, certain foods, and physical factors like pressure from clothing.

    • Treatment typically involves antihistamines, like Allegra, which you are already taking. In some cases, other medications may be needed.

  • Mast Cell Activation Syndrome (MCAS): This is a condition where mast cells, a type of immune cell, become overactive and release chemicals that can cause a variety of symptoms, including hives and swelling. Triggers can include stress and certain foods.

    • Treatment often involves avoiding known triggers and medications to control symptoms.

  • Autoimmune disorders: Some autoimmune disorders can cause chronic hives and swelling. These conditions occur when the immune system mistakenly attacks the body's own cells.

    • Treatment typically involves medications to suppress the immune system and control symptoms.

What you can do

While waiting for a formal diagnosis, here are some steps you can take:

  1. Continue taking your antihistamine as prescribed.
  2. Try to avoid known triggers as much as possible.
  3. Keep your skin moisturized to help reduce itchiness.
  4. Over-the-counter creams or ointments containing hydrocortisone may help with itchiness and swelling.
  5. Keep a symptom diary to help identify any potential triggers or patterns.

What you should look out for

Please seek immediate medical attention if you experience:

  • Difficulty breathing or swallowing
  • Swelling in your throat
  • A sudden increase in the severity of your symptoms

Remember, this advice is intended to be general in nature, and specific causes may not apply to your personal circumstances. Always consult with a healthcare provider for appropriate examination, testing, and care.

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9 mo ago

People Also Ask

What are the common triggers for chronic urticaria?

Common triggers for chronic urticaria include stress, certain foods (especially those high in histamine), physical factors like pressure from clothing, temperature changes, and sometimes infections or medications.

How does Allegra help in managing chronic urticaria symptoms?

Allegra is an antihistamine that helps manage chronic urticaria symptoms by blocking the action of histamine, a chemical in the body that causes allergy symptoms like itching and hives.

What is Mast Cell Activation Syndrome and how is it related to hives?

Mast Cell Activation Syndrome (MCAS) is a condition where mast cells release excessive amounts of chemicals, including histamine, leading to symptoms like hives and swelling. It is related to hives as both involve the release of histamine.

When should someone with chronic urticaria seek immediate medical attention?

Someone with chronic urticaria should seek immediate medical attention if they experience difficulty breathing or swallowing, swelling in the throat, or a sudden increase in the severity of their symptoms, as these could indicate a more serious allergic reaction.

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