Patient: Hi. For over a week I have been covered in huge hives on my bilateral arms, abd, and breast. Each day I wake up they are progressively worse. My lips are intermittently starting to swell. The only time this has ever happened before was 6 years ago when I was pregnant with my son and they lasted my entire pregnancy. I currently have a paragard iud in. Took a pregnancy test which was negative, but I’m not due for my period for 2weeks. I have no other allergies and have not changed anything in my routine. I have been living on benadryl and zertec which helps a little but the hives never truly go away. My entire family and coworkers are convinced I am pregnant as this is how I presented last time. Went to see an allegist 6 years ago, couldn’t find anything Except that I was pregnant. I’m not sure what to do next. Afraid I might end up anaphylaxic waiting to take another pregnancy test. Help!!
Doctor: Hello. Welcome to ask the doctor.I have read your query.I understand your concern.Urticaria can be acute, chr onic and acute on chronic. When duration of the disease is more than 6weeks, it is known as Chronic Urticaria.It is characterised by red colored itchy transient eruptions over body. It can be caused by allergy to recent infection, any food, seasonal change, drugs, pollen grains etc.Pregnancy is not as such related to urticaria. Most of the times, the offending agent is not traced.However, I have mentioned the most likely causes responsible for causing urticaria.In such cases, I prefer to advise combination of levocetirizine and montelukast to my patients.You should get your Thyroid profile , Absolute Eosinophil count, IgE levels done.You can share my opinion with your doctor.I hope it helps.Stay healthy