Archive for August, 2009

chronic hives

The hives are denfined as lasting longer than six weeks. when they become chronic the hives can become severley itchy.the prurities can kee people awake for several hours each destroying their sleep or waking hours. Total or substantial hives on the body can make people unable to participate in the daily activities of life. Chronic hives are most likely caused by autoimmune or infectious causes. Such markers as antithyroid peroxidase or thyroglogulin can indicate a tendency for autoimmunedisease. positive double stranded DNA Rheumatoid factor or sjogrens aantibody can indicate a tendency towards rheumatoid disease. Other blood measures can indicate incpient diabetes. Elevated immunoglobulins indicate a tendency towards autoimmune ddisease and positive viral titers to hepatitis c can indicate an active infection causing the hive Most patients who have hives over three months are unable to find the cause. We usually chec a CU index or antibodies against their own mast cells with ige receptors. Usual treatments involve using H1 receptor antagosnist such as fexofenadine or levocetirizine.Singulair can be added as a secondary agent. Severe itching and painful rashed sometimes demand a skin biopsy to see if their is a neutrophilic infiltrate. If so one may have to consider immune modualtors such as cyclosporin ,dapsone or plaquinil. further updates to follow arthur lubitz

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chronic hives part two

sometimes peoples hives are severe . They can go on for years and create major itching wihich is a low level of pain. The patients have an inability to concentrate or sleep interfering with their life.Usually we will increase the antihistamines above the normal levels. The patients continue to struggle with symptoms. Prednisone is used to acutely control the symptoms. However steroid sparing agents such as cyclosporin dapsone cellcept and plaquinil have been used to control chronic urticaria arthur lubitz m.d. FAAAAI

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Chronic Hives

Chronic urticaria is defined as hives that last three months or more.chronic hives are mostly caused by autoimmune phenomenon such as andtibodies against thyroid or skin structures . An example would be antibodies against double stranded DNA or rheumatoid factor which are seen  in Systemic Lupus Erythematosis or Rheumatoid Arthritis. In Most cases the patient may have positive antibodies without the disease. Sometimes if the lesions are painful it is worth getting a skin biopsy to rule out vasculitic urticaria. autoimmune hives are very intense in their symptoms and sometimes require multiple antihistamines to control the symptoms. arthur lubitz md

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