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Suggest Treatment For A Severe Case Of Hives
Question: My wife has been suffering from a severe case of hives for several months and has been to ER, different doctors and have been tested for different causes including dander from dog hair, and other issues. We recently discovered a small patch of mold in Master bedroom and we are presently seeking roof and mold removers though our insurance carrier. What other solutions do you recommend?
Brief Answer:
Avoid further exposure, temporarily. Blood tests, steroid nasal spray.
Detailed Answer:
Hi,
Thank you for your query.
1. If the age of the Earth (4.6 billion years) is considered as a 12 hour clock, the first fungus appeared at 8 o'clock (about 2 billion years ago). Humans in comparison have been on this planet since 11:56 (about 4 minutes).
2. It is estimated that there are 8-10 tonnes on fungus as against each person in this World. Hence fungii are omnipresent.
3. While it is true that your wife may be having an allergic reaction to fungus (mold), it need not be within her body to cause the reactions. For unknown reasons some people react to contact or presence of the fungus with an immune dysfunction that has systemic (body wide) reactions (such as hives, dermatographism).
4. Check for an eosinophila, raised ESR, IgG1 deficiency and signs of inflammation in the nose and sinuses with an examination, Sinus CT & Chest X-ray (since any fungus is more likely to be inhaled). Concurrent diseases which may cause decreased immunity such as diabetes must be ruled out.
5. There is no standard treatment. You are already receiving steroids and anti-histamines. Removing her from further exposure by temporarily shifting to another premises may help narrow down the diagnosis. Steroid nasal sprays may help reduce inflammation. Systemic anti-fungals may be tried.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Avoid further exposure, temporarily. Blood tests, steroid nasal spray.
Detailed Answer:
Hi,
Thank you for your query.
1. If the age of the Earth (4.6 billion years) is considered as a 12 hour clock, the first fungus appeared at 8 o'clock (about 2 billion years ago). Humans in comparison have been on this planet since 11:56 (about 4 minutes).
2. It is estimated that there are 8-10 tonnes on fungus as against each person in this World. Hence fungii are omnipresent.
3. While it is true that your wife may be having an allergic reaction to fungus (mold), it need not be within her body to cause the reactions. For unknown reasons some people react to contact or presence of the fungus with an immune dysfunction that has systemic (body wide) reactions (such as hives, dermatographism).
4. Check for an eosinophila, raised ESR, IgG1 deficiency and signs of inflammation in the nose and sinuses with an examination, Sinus CT & Chest X-ray (since any fungus is more likely to be inhaled). Concurrent diseases which may cause decreased immunity such as diabetes must be ruled out.
5. There is no standard treatment. You are already receiving steroids and anti-histamines. Removing her from further exposure by temporarily shifting to another premises may help narrow down the diagnosis. Steroid nasal sprays may help reduce inflammation. Systemic anti-fungals may be tried.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
1st line unclear. Do you mean I should do blood tests and take steroid nasal sprays or avoid them? I have already done some blood tests. Am not allergic to my dogs.
You do not address the additional info I sent about allergies to meds and that I had the same reaction to a blood pressure med I had been on for years at the exact same time of year (last year I broke out in hives in mid October just like this year). But when I was stopped on the Vasotec last year my hives cleared up. This year I am on Losartan and a pharmacist said it is a cousin to Vasotec and I should not be on it. My allergist said it is not related to Vasotec so I am at a loss as to whether the Losartan caused the same problem as last year's hives. I have been off the Losartan for 5 days and have had hives for nearly 3 months. I now take Amlodipine in place of Losartan, and also take Levothyroxine and Omeprazole, both of which I have taken for years though originally took the non-generic forms. Wonder if I am allergic to the binders in the generic and if there is a way to ascertain that. Also the Levothyroxine lists its first side effect as HIVES. Again, I have been on the Prilosec And then Omeprazole for years and the same holds true for the Synthroid and Levothyroxine.
Mold in the bedroom is a relatively new occurence. I am diabetes type 2 but not a need for meds or insulin and I have had the dermatagraphia since birth.
You do not address the additional info I sent about allergies to meds and that I had the same reaction to a blood pressure med I had been on for years at the exact same time of year (last year I broke out in hives in mid October just like this year). But when I was stopped on the Vasotec last year my hives cleared up. This year I am on Losartan and a pharmacist said it is a cousin to Vasotec and I should not be on it. My allergist said it is not related to Vasotec so I am at a loss as to whether the Losartan caused the same problem as last year's hives. I have been off the Losartan for 5 days and have had hives for nearly 3 months. I now take Amlodipine in place of Losartan, and also take Levothyroxine and Omeprazole, both of which I have taken for years though originally took the non-generic forms. Wonder if I am allergic to the binders in the generic and if there is a way to ascertain that. Also the Levothyroxine lists its first side effect as HIVES. Again, I have been on the Prilosec And then Omeprazole for years and the same holds true for the Synthroid and Levothyroxine.
Mold in the bedroom is a relatively new occurence. I am diabetes type 2 but not a need for meds or insulin and I have had the dermatagraphia since birth.
Brief Answer:
Atopy. Stop or replace current medication.
Detailed Answer:
Hi,
Thank you for writing back.
1. There is a character limitation (75 characters max) for the first line, which is a summary or brief answer (to be read in context with the main answer). You should take the blood tests and steroid nasal spray.
2. You have probably asked multiple questions. This particular one contains no reference to any hypertensives, thyroid hormone replacement, anti-reflux medication or whether it specifically pertains to your wife, if you are writing on her behalf.
3. The dermatographism from birth signifies 'atopy'. The person is hyperallergic to various allergens. True allergy to multiple drugs is rare. Hence you are correct that these reactions can occur to commonly used coloring agents, binder, stabilizers, fillers and preservatives added to medicines.
4. The best way to check is to stop or replace the medication suspected to be causing the reaction. This is possible with anti-hypertensives and anti-reflux medication but difficult with thyroid hormone medication. All these medications can cause hives. Sometimes these hives start after prolonged use.
5. Steroids are the mainstay of treatment of atopy if it persists after avoiding the triggers. The mechanisms and cause is unknown. You may get the immunoglobulin levels checked and try immune modulators.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Atopy. Stop or replace current medication.
Detailed Answer:
Hi,
Thank you for writing back.
1. There is a character limitation (75 characters max) for the first line, which is a summary or brief answer (to be read in context with the main answer). You should take the blood tests and steroid nasal spray.
2. You have probably asked multiple questions. This particular one contains no reference to any hypertensives, thyroid hormone replacement, anti-reflux medication or whether it specifically pertains to your wife, if you are writing on her behalf.
3. The dermatographism from birth signifies 'atopy'. The person is hyperallergic to various allergens. True allergy to multiple drugs is rare. Hence you are correct that these reactions can occur to commonly used coloring agents, binder, stabilizers, fillers and preservatives added to medicines.
4. The best way to check is to stop or replace the medication suspected to be causing the reaction. This is possible with anti-hypertensives and anti-reflux medication but difficult with thyroid hormone medication. All these medications can cause hives. Sometimes these hives start after prolonged use.
5. Steroids are the mainstay of treatment of atopy if it persists after avoiding the triggers. The mechanisms and cause is unknown. You may get the immunoglobulin levels checked and try immune modulators.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
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