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Had Hives, Red Streaks And Bruising On Legs. Blood Work Showed Elevated Hgb And Hct. Suggest?

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Posted on Sat, 19 Oct 2013
Question: Hi! In the last week or so I have had hives, red streaks appear and bruising all down my legs, I have had triple negative breast cancer, mrsa, shingles, bells palsy and hpv. I had blood work done yesterday and have elevated hgb and hct. Should I be worried or ask for other tests?
I forgot to say I have the Bracai 1 gene and had a double masectemy and ovaries out. I generally feel good, but last week felt very fatigued and flu-like. The red streaks appeared near my hips/buttocks not close to any previous surgery. I also had chemo and radiation. This all happened in the last 4 years.
doctor
Answered by Dr. Kalpana Pathak (6 hours later)
Brief Answer:
Please read a detailed answer below

Detailed Answer:
HI,
Thanks for writing to us.
Firstly I would like to mention the onset of hives, red lines are not linked with your previous medical condition.

These hives and linear red streaks( dermatographism) are basically manifestation of acute urticaria. In most of the cases, there is no underlying cause but sometimes any acute infection like flu, fever can precipitate urticarial rash. Other causes could be worm infestation, food induced, drug induced etc
As you have mentioned that last week you had symptoms of flu, so this could have been associated with your urticaria episode.

Now to treat the same, take tablet levocetirizine twice in a day and apply calamine lotion to soothe the itchy areas. If you achieve complete response with the same, continue medication atleast for a week and then taper the dose of levocetirizine to once in a day for a week . Also avoid sour food, preservative containing foods like pickles, jam , sauces, tinned sea foods etc.
No tests are required right now.
Hope this helped.
Take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kalpana Pathak (4 hours later)
Hi! First what is levocetirizine and where do I get it?
I have had hives off and on all my life, and visited many allergists. I am not that concerned, as they have never found what I was allergic to, but it eventually goes away.

The red streaks are completely different. They are more like bruises, with pinpoints of blood at the surface, forming streaks. I also had spontaneous bruises all up and down my leg, that came over night as I slept. This combined with slightly off blood work has me concerned for blood clots, or a bleeding disorder. You said the hives could be a manifestation of an infection, could it be the dormant shingles, or could mrsa be attacking my body? I was in the hospital for 22 days on iv with mrsa. I don't want to be a hypochondriac, but I feel my body is trying to tell me something, and don't know what. After all these years of allergy tests, I am convinced the hives are not an allergy, but as you said an infection. I also had tuberculosis as a small child. What does elevated hgb and hct mean?
doctor
Answered by Dr. Kalpana Pathak (39 hours later)
Brief Answer:
Please read a detailed answer below

Detailed Answer:
Hi,
Thanks for writing back. Also please accept my apology for a detailed response.
Levocetirizine is an oral antiallergic which is easily available over the counter.
Infection is usually a cause of acute onset urticaria. But as you have mentioned that you had urticaria almost all your life, So I do not think that your recent episode of MRSA infection or tuberculosis or shingles can be linked to it. But still acute infections like MRSA or flu can precipitate or flare up existing urticaria. This is known as acute on chronic urticaria. The cause of urticaria in many cant be ruled out.
now these linear streaks can still be dermatographism. Due to severe itching, pin point bleeds may occur.
I am not ruling out bruises or petechiae , that can only be done once you have attached an image of these lesions. For the same, please attach an image of these lesions. Blood clots or Deep vein thrombosis an only occur, if a person is bed ridden for long.

Hgb or haemoglobin, hct or haematocrit if low mention that a person is anaemic.

Hope that helped you. Also please attach the pics for further discussion. If having doubts that these are spontaneous bruises or DVT, then please consult your doctor. Tests like platelet count, clotting time, bleeding time and colored Doppler might be required to rule these out apart from clinical examination.

Take care
Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Kalpana Pathak

Dermatologist

Practicing since :2006

Answered : 2014 Questions

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Had Hives, Red Streaks And Bruising On Legs. Blood Work Showed Elevated Hgb And Hct. Suggest?

Brief Answer:
Please read a detailed answer below

Detailed Answer:
HI,
Thanks for writing to us.
Firstly I would like to mention the onset of hives, red lines are not linked with your previous medical condition.

These hives and linear red streaks( dermatographism) are basically manifestation of acute urticaria. In most of the cases, there is no underlying cause but sometimes any acute infection like flu, fever can precipitate urticarial rash. Other causes could be worm infestation, food induced, drug induced etc
As you have mentioned that last week you had symptoms of flu, so this could have been associated with your urticaria episode.

Now to treat the same, take tablet levocetirizine twice in a day and apply calamine lotion to soothe the itchy areas. If you achieve complete response with the same, continue medication atleast for a week and then taper the dose of levocetirizine to once in a day for a week . Also avoid sour food, preservative containing foods like pickles, jam , sauces, tinned sea foods etc.
No tests are required right now.
Hope this helped.
Take care