Cholinergic urticaria

[ctmartin]

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             Hi, all!  Does anyone have any anecdotal information on this condition?  After puzzling over my PN/sesame allergic daughter's somewhat severe allergic reactions following physical activity, the doctor's "best guess" was not exercise induced ana, but CU (also based on hives she has had when emerging from the shower).  I wanted to know if anyone else suffers from CU, and what their experience/treatment has been?

The doctor recommended putting my daughter on a daily antihistamine ... she has never been on anything like that before.  She recommended Zyrtec, but because I am unfamiliar with long lasting antihistamines, I don't know if this is the best one for her condition?  She also recommended doubling up on days of physical exercise.  My daughter is planning to resume PE on Monday after sitting out since August.

Thank you for any insight!!

[spacecanada]

Someone just posted about this today in my local allergy group.  I don't know much about it but they made it seem like daily antihistamines made it easier to live normally. They also suggested quick baths instead of showers, with a special treatment added to the water recommended by her allergist to reduce hives.

It seems like this is becoming more common, or perhaps awareness has grown recently. I hope your daughter and you allergist will work to make life easier.

[PurpleCat]

When my DD was younger she took daily antihistamines, now she only takes them during tree pollen season.  She did not have any issues other than needing to change brand when they did not seem to work anymore.  In the past, we started with Clariten, then Zyrtec, then Alavert, and now she uses when needed Allegra.

[lakeswimr]

What were her symptoms in that reaction?

[GoingNuts]

I had to look it up - I didn't realize it was "heat" hives.

I used to get these when I was younger, and never realized it was unusual.  I didn't get them all over, however.  If I was running, I got them on my legs.  If I didn't break out in actual hives, I itched like crazy.

I haven't had them in years.  Then again, I don't run anymore either. 

[ctmartin]

thanks, all!

lakeswimr:  symptoms were sneezing, congestion, allergic "sunburn," hives, facial swelling.  doctor based her diagnosis on (1) hives from passive heat and (2) size of hives (i had pictures).  i thought for sure that it was EIA, but she told me that people with EIA do not suffer from passive heat reactions (i.e.  from a bath or shower) and the hives are very small like my daughter's (even though, eventually, the hives were unrecognizable and simply looked like swelling).  apparently, there is a test to confirm this condition, but since it is rare (even at Mt. Sinai), they do not always have the test in stock.  needless to say, i was a bit disappointed, as a positive result would have been helpful, but a negative result doesn't mean she doesn't have it (if that makes sense?).  i am going to try to have the test done locally, but i called a doctor on friday who had never even heard of it 

my daughter started on children's zyrtec yesterday and i must say, we have seen immediate results.  she took a shower within an hour of her first dose and, voila, no hives!  fingers crossed that this will help with the active heat reactions as well. 

purplecat:  thank you ... how old was she and how many years was she on a daily antihistamine?  i absolutely hate her having to take meds daily ... completely against it ... but we have been living in fear for the past 5 months, and if this helps us relax about her being active, well then it is worth it, at least for the short term. 

on another note ... i learned a valuable lesson about allergy testing.  we took a blood test ahead of our visit to Mt. Sinai, as we were travelling from out of state and I figured that it might be valuable to have current allergy testing results in hand when we got there.  i was sure that my daughter must have developed some new FA and that is why she was experiencing these reactions.  we got the results a few days before our doctor's visit, and i hit the roof.  her blood tests (which she has never had before) basically had her allergic to everything she has been eating ... milk (class 3!), wheat, egg whites, soy, corn and every environmental allergen under the sun.  she turned up a class 5 to cat (and we have a cat)and she has never had any symptoms around him.

i tried to put it in perspective, that she has consumed and been exposed to these things without reaction, and sure enough the doctor said we should not have had such a test done.  she even skin pricked her for milk and wheat, which both turned up negative, to show me that these were false positives.  i'll never do that again!!

[PurpleCat]

Yes, reaction trumps testing!  Always!  There are some things that my DD tests positive to that she can and does eat (allergic to apples, yet can and does eat them).  There are categories she tests positive for but she can eat one thing within the catagory without reaction, yet can not eat any others (allergic to shellfish:  can eat and does eat shrimp, can not eat lobster or crab)

Always a weird puzzle and each individual is different.

My DD started on a daily antihistamine some time around age 4 and was on one year round for I think 3 years until her asthma was well controlled and then we switched to Feb - July and Oct - Nov for a couple years and after that, Feb - July to cover tree pollen season until last year because she started allergy shots.

My DD does (and has since she was 4) take daily Singulair and Nasonex for her allergies and Advair for her asthma 365 days a year.  The antihistamine is in addition to these daily meds.