13 year old with severe hives

[milkysmum]

Just to start by saying I have taken dd to urgent care this afternoon on advice of pharmacist, after she broke out in hives and her lips swelled.
Doctor at urgent care said she had clearly had an allergic reaction to something but couldn't say what. Considered sending her over to A&E in the next town but as her lips had gone down and breathing was normal agreed to discharge home with Piriton and Prednisolone and to arrange bloods with GP next week.
DD has experienced mild swelling to her hands before but we've never been able to pin point cause- never had hives like this though or the swelling to lips.
Any ideas what it could be? Is it worth paying for allergy testing do you think or will GP do this?

No advice but omg your poor DD. I get unexplained hives nowhere that bad. The itch is horrendous. Warm not hot bath, fill a sock with raw porridge oats and tie it off then add sock to the bath. It gives some relief. Good luck. She's a brave young woman.

What has your daughter eaten today? I have histamine intolerance syndrome and whilst I am not allergic to anything, if I eat a lot of high histamine foods then I get hives, wheezing and my lips swell up, can start vomiting.

There is also something called oral allergy syndrome that my son suffered from last year when he had hay fever. When eating certain fruits his body reacted as if he had ingested pollen and his mouth started swelling and tingled.

It is most common for them to surge in the evening and be best in the morning. I'm so sorry she must be so uncomfortable.

Gosh, your poor daughter! That looks nasty.

My DSis has a reaction like that to strawberries but she starts going in to anaphylactic shock too, so do keep an eye on her and make sure she's not getting sleepy.

Hers suddenly sprung up when she was a teenager so maybe a hormonal change?

Could it be related to heat/sweat maybe if you can't tie it to anything she's eaten or touched? I get hives as a result of heat but nowhere near like that - only in the spots I get hot.

Poor thing - it could be anything that has suddenly kicked this off - if food isn’t a likely culprit then do look at washing up liquid, soap, moisturisers, laundry detergent. It may take a while for symptoms to settle.

The only thing she had eaten today is poached eggs on toast late morning. She didn't eat eggs the day before yesterday when she had the initial reaction though.
She's asleep now as the piriton has made her a bit drowsy thankfully!

I had similar when I had my BCG vaccination. After the Daisy wheel skin prick test I had several incidences of hives. I went to see the dr and he told me to try cutting out a list of common allergens. As it wasn't concentrated at the site of the skin prick no one linked the two. I went ahead and had the vaccination and later that day had hives worse than those pictured. My wrists swelled to the same width as my hands and I was covered in them. The GP gave me one tiny pill and it all went down. However I have no idea what he gave me!

Your doctor will likely run some allergy tests. Our daughter has multiple severe allergies, and has had reactions ranging from classic anaphylaxis to large skin welts like your daughter. It is extremely uncomfortable for them, and unfortunately not always much they can do, other than monitor and take daily prescribed antihistamines. Our daughter is 12, and has had suffered with this since she was 2. She goes through phases, depending on pollen seasons etc, and her food allergy list, has grown over the years - which they retest every 3 years or so, unless she has had a severe reaction, in which case they test quicker. I really hope your daughter's condition improves soon.

Hi all, just to update.
I went to GP who agreed looked like allergies and referred dd to hospital for allergy tests ( bloods). Still waiting for results and due to bank holiday and surgery being closed Thursday/ Friday we now won't get results till next Monday.
Yesterday on waking dds eyes were so swollen she could hardly see, the swelling reduced though on taking some piriton and had almost gone now. The hives had almost gone but today they have started again on her leg and on a finger randomly. She's so upset. She slept most of yesterday and her appetite is reduced. She said she can't go out as they look so terrible and doesn't know what is causing them- the thought of school Monday if the hives are still appearing will be impossible for her I just know it will. Have started a diary to try and see any pattern.

Do you know what the bloods were for?

Has the GP suggested prophylactic antihistamines, eg a one a day AH, to prevent/reduce reactions?

Hi My DD had similar after a virus. If they keep recurring it is unlikely to be an allergy as there is no immediate stimulus. DD was diagnosed with spontaneous urticaria and had to take antihistamines a few times a day for a month or so, gradually reducing the dose until they stopped coming back. It’s fine to take daily antihistamines. Dr Tabi Leslie is a specialist in this area - if you can get referred to her it is so worth it.

GP said the bloods were allergy tests to common allergens ( I think dairy, wheat, pollen etc..?)
DD wasn't unwell prior to the hives starting and is only tired now due to the piriton. She doesn't appear to have had a virus but obviously I don't know that for sure.

This happened to me a few years ago. As pp mentioned, it was chronic idiopathic Uticaria with angioedema (the mouth/eye/tongue swelling) - basically unexplained hives. It was exactly as you are describing and came out of nowhere - and it wasn’t an allergy. It would disappear and then randomly I would be covered again. It got worse and worse as the days went on, and eventually I would be covered from head to toe several times a day. I had a scary trip to A&E because my tongue swelled up and on another occasion my husband had to call 999 because my throat started to close. I had a battery of blood tests but they never found a cause for mine (sometimes it can be thyroid or hormone related, or the after affect of a virus as mentioned before) it went away randomly over the first lockdown, but I was taking a very high dose of antihistamine plus some other drugs that are known to be effective (one is for asthma, the other is stomach related, I can’t remember the names!)

be careful with the steroids because they do work but they aren’t a long term fix, and they are what I was prescribed by A&E and the GP before I was diagnosed because that’s all they know that will stop the hives. You need her to see an allergy specialist that deals with immunology - it isn’t an allergy but it comes under this remit. If you can go private I would really consider it, just to get a fast diagnosis - because honestly you could go round the houses looking for an allergy when this is so typical of chronic idiopathic urticaria but is not something GPs are very familiar with (in my experience). My GP was very reluctant to prescribe a high dose antihistamine but the allergy specialist wasn’t, and the GP would never have prescribed the other combination of medication that I was on.

It’s a horrible condition and can be very scary - I was told to avoid any kind of ibuprofen type drug as this can exacerbate it (I was told this after I had taken ibuprofen and my throat started to close) I can now take ibuprofen again, it seems to only be an issue when the condition is ‘active’.

If you are near London I am happy to recommend the clinic I went to - (they transferred me over to the nHs list once I had been diagnosed, and it only took 1 appointment for diagnosis). There’s a few threads on here that I found useful, if you do a search (that’s how I figured out what it was!) and there’s a very helpful Facebook group as well. I really sympathise with her not wanting to go out, I absolutely hated it when I had a flare up on my face and had to go anywhere - once my medication was sorted that never happened again, there is hope!

www.allergyuk.org/types-of-allergies/urticaria-hives-other-skin-allergy/

Has she dyed her hair recently? New make up? Moisturiser? Been stung by anything? From my experience that’s unlikely to be food related.
Does anyone she sees have a new pet?
Sorry OP, there’s so many possibilities. Any new medication? Anyone in the house changed perfume or deodorant? New bubble bath?

How bizarre! I've had these this week too! Dr has prescribed a strong antihistamine and I need to go back if they haven't gone by next week.

I've been through everything I can think of (washing powder, shower gel etc) and I haven't changed anything. We have all eaten the same too nothing new or different.

I suffer with dermographism, it also comes with hives. Up until now I have had no cure and it has been ongoing for 9 months. I find fexofenadine is helpful relieving symptoms and doesn't have the drowsiness of other antihistamines. These are now available in most supermarkets and chemists if you want to try something that doesn't cause drowsiness. Hope your dd finds relief soon, I feel for her.

Oooh! Poor thing!! They look awful!

I have had them come up that badly a couple of times and have also noticed that my neck glands have been swollen so have concluded that it was an allergies reaction to a virus that my body was fighting off. The only other thing that kicked it off that badly was having a flu vaccine one year - that started it off within a couple of minutes if the injection and they got worse and worse until similar to your daughter’s within a couple of hours. Took a shed load of anit-histamines but still took several days to go slowly fading.

My youngest daughter has also had to same reaction and each time it has also been at the at start of her going down with a virus.

Therefore my thoughts are that she may got a virus and her body is reacting to that? Are the glands in her neck swollen? If so then her body is fighting something. In which case, loads of anti-histamines, probably some Calpol and hopefully it will wear off in a couple of days. Usually takes me (and my daughter) about three days for it to ease off.

Thank you for all these really helpful comments. She hasn't died her hair. She does use lots of make up/ fake tan etc but nothing new.
We are not near London no unfortunately- up in Lancashire. The idiopathic urticaria does sound like a possibility on reading up on this, so should I still ask for a referral then if bloods come back clear for allergens?
The hives seem to keep changing in appearance also, from being raised and lump, to flatter and more bruised like?

looks like urticaria to me. I’ve had it twice unfortunately no reason found, the first was for six weeks fairly mild, second occasion was just for two weeks but very intense, this 20 years ago never had it since.
i found ice on the hives soothed them and also chicken pox type soothing lotion. Of course took anti-histamines.

I have spontaneous and cholinergic urticaria (and am in the same area!)
At the minute I take cetirizine - 20mg twice a day but fexofenadine is what I've been on previously. Salford have a great urticaria department, I was referred to them and am now on Xolair
It won't do any harm for now to keep taking the piriton whether she has the hives or not in the hope it damps it down a bit

My toddler had hives not as big as your daughters but they randomly appeared everyday for about two weeks. One minute he was fine the next he'd be covered no tounge or mouth swelling thankfully. They went and haven't returned it's been about 12 months I think.

Had another trip to urgent care at the weekend as the hives and swelling were so severe dd could not walk up the stairs due to the pain, and she began with pain in her throat. After a few hours sat in an over crowded waiting room the throat pain had gone completely though and we were sent away again with more piriton and Prednisolone and told ' hives are just one of those things some people get'.
DD had been so distressed and then felt like she had wasted their time.
Allergy bloods came back today showing positive for egg white allergy. She's never had problems with eggs before. I have a telephone appointment with GP tomorrow to discuss further.

So sorry she's still suffering.

It might be worth taking her BP and HR when she's having these episodes and take pics of any visible swelling (especially mouth/throat).

I would be pushing for seeing a specialist asap.