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Dr. R. Bora
Dr. R. Bora, Doctor
Category: Health
Satisfied Customers: 5233
Experience:  14 years experience in the emergency room.
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Hello, my name is XXXXX XXXXX I am hoping someone out there

Customer Question

Hello, my name is XXXXX XXXXX I am hoping someone out there can help me. I am 34 years old, and have never had any allergies to anything. Suddenly 2 weeks ago, I broke out in hives, and they haven't stopped yet. They come and go. I have eliminated anything new, and run out of ideas. It seems to happen at random times, but there are always at least a few. It started on my arms, and slowly, expanded to my legs, abdomen, chest, feet and hands. 3 days ago, my botXXXXX XXXXXp swelled, and the next day under my eyes were swollen. Now, last night, my hands started feeling like blood was pooling in them, and they felt swollen. They burned so bad I could barely stand it. It went away after about 15 minutes, but keeps coming back for a few minutes at a time. Right now, my toes are feeling the same way. I am really starting to worry. I just signed up with new health insurance, and it does not kick in until may 1st. Please I hope someone can help me. Thank You in advance.

Submitted: 1 year ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 1 year ago.
Greetings Nicole.



I am sorry that your question was unanswered for very long.



Your symptoms are very likely to be chronic hives or urticaria. The major causes of urticaria are;



1) Foods or food additives

2) Inhalation, ingestion of, or contact with antigens

3) Drug reactions

4) Infections: bacterial, fungal, viral, and helminthic/parasites

5) Insects (papular urticaria)

6) Cold urticaria

7) Aquagenic (water) urticaria

8) Solar (Sun) urticaria

9) Chronic autoimmune (problems of immunity) urticaria

10) Chronic idiopathic (unknown reason) urticaria



So it is a sort of detective work to find the cause.



Oral anti-histaminics are effective and you may try Benadryl.



Please read the resource;



http://www.mayoclinic.com/health/chronic-hives/DS00980



A chronic urticaria is treated as following;

1) A consultation with an allergist.
2) Avoid foods with known food allergies. You may keep a food diary and on the day of aggravation, may be able to know the possibility of likely food which may have been responsible.
3) Avoidance of mental stress over tiredness, alcohol, nonsteroidal anti-inflammatory drugs, and tight-fitting garments.
4) Psychologic stress can trigger, so taking care of those factors.
5) Night time symptoms (if you have any) are helped by lukewarm bathing and keeping the temperature of the bedroom slightly low.
6) Itching, if present, is significantly helped by menthol and phenol cream.
7) Non sedating antihistamines. Cetirizine too can help, apart from Benadryl.
8) Hydroxyzine or doxepin in night time.
9) Colchicine or dapsone is given who do not respond to above.
10) Autoimmune urticaria should be investigated and one may benefit from methotrexate or cyclosporine.



Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using JustAnswer.


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Customer: replied 1 year ago.

I am sorry, but everything you told me I found out on the first day of the hives. I have eliminated everything possible. And urticaria does not explain the blood pooling in my extremities.


 


 

Expert:  Dr. Arun Phophalia replied 1 year ago.
Hello Nicole,

An autoimmune urticaria can cause blood pooling in the extremities. An autoimmune neuropathy or vasculitis too would have same symptoms. The investigations necessary to establish the cause of autoimmune issue are;

1) Complete blood count,

2) Erythrocyte sedimentation rate,

3) Skin (dermal) allergy tests,

4) Muscle enzymes;

5) Anti-nuclear antibodies (ANA)

6) In vitro allergy test

7) Anti-dsDNA

8) Anti-Sm

9) Anti-SSA (Ro) or Anti-SSB (La)

10) Coombs test

11) Anti-histone

12) Total eosinophil and vacuolated eosinophil counts.

You may try anti-allergy medication. If the hives and pooling of blood responds; this would be therapeutic test for confirming the diagnosis. An autoimmune urticaria would need other prescription medications too.

It is privilege assisting you.
Customer: replied 1 year ago.
Relist: Other.
Did not tell me anything that was not readily available on google.
Expert:  Dr. R. Bora replied 1 year ago.
Hello, I am DR. BORA. Since you have relisted the question, I would like to help you.

First, I would like to know:

1. Do you have any other symptoms like joint pain?

2. Any redness in the toes or fingers?


I am still available online to respond after you answer my query / queries.
Customer: replied 1 year ago.

thank you. Yes, over the last few months I have experienced pain in my Left Hip and Shoulder. My fingers do get red when they feel swollen and painful. Im not sure about my toes.


 


 

Expert:  Dr. R. Bora replied 1 year ago.
I think your symptoms like joint pain, feeling of blood pooling and the hives are likely to be related. Hives is just a clinical symptom of some other changes in your body.Now, to estimate the correlation, you will have to see an internal medicine MD first who would clinically examine you and would order some lab tests like the following:

1. Comprehensive blood metabolic panel

2. ESR / sed rate and eosinophil count.

3. Antinuclear antibody.

4. Anti Ds DNA antibody.

5. Ant Sm antibody.

All the above tests will tell you if there is some inflammation going on inside your body which could be responsible for the pain and the hives.
Depending on the results of the test you may have to see a rheumatologist, if the antibody tests are positive. But you definitely should see an MD at the earliest.

If you have any further question, I would be happy to help you.


I hope my answer has helped you.



Please remember to choose accept or to rate me excellent service ( 5 or 4 positive rating)to give credit for my answer and time.Bonuses are warmly appreciated.
Dr. R. Bora, Doctor
Category: Health
Satisfied Customers: 5233
Experience: 14 years experience in the emergency room.
Dr. R. Bora and 4 other Health Specialists are ready to help you
Customer: replied 1 year ago.

I am going to see an MD as soon as my insurance kick in. Thank you for connecting the symptoms. What are the possibilities if any of the tests are positive?

Expert:  Dr. R. Bora replied 1 year ago.
Sorry I was offline and could not reply back immediately.

The chances are at least 60 to 70 % chances of the tests being positive.

Thanks for the accept and have a nice day!

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