Severe Hives in 5YO - HELP!

[Beppie]

This is the timeline:
8 pm last night - dd showed us her itchy tummy, which was covered in a rash. Not a rash with little red bumps, more like the entire belly had raised skin, pink, and inflamed. very itchy.
We were alarmed but we decided to give her Benadryl... that temporarily made her feel better, while we racked our brains trying to think of what the cause could be. She took a cold shower, and went to bed.

12 am -- dd woke up with extreme itchiness. the hives had spread to her face, and legs. DH took her to the ER (four blocks from our house) and came home with Prednisone.

She seemed a bit better by morning. But after breakfast, late morning, she started getting another flare-up... more prednisone and benadryl later, not much better, and around 2:00 she was going crazy with hives.

2:30 DH took her to the clinic again, and they gave her 2 shots with medication for immediate relief (the hives were worse than ever before).

Now (after the shots) she looks much better. The rash has left her face for the most part. Her arms still have red rash on them. But I am thinking only of how long this will last. I'm sure that the hives will re-emerge once the medicine wears off.

How do we begin to find out the cause? Is it milk allergy? Wheat allergy? Where do we even start? What foods are safe for her to eat when we are starting from scratch, trying to find the cause?

I'm overwhelmed with the possibilities and the worry.

[Beppie]

what are safe foods?

Now dd tells me she's hungry --- what can I give her that I know is safe? What are safe foods? I looked in the allergy resources section at the beginning of this thread and couldn't find any immediate answers. Please give immediate help! I don't know what to feed her today for dinner or tomorrow for breakfast, lunch, etc. thanks so much!

[kjbrown92]

What did she eat last night for dinner (or after)? Chances are, it's one of those foods, since hives are pretty fast acting, no? She's never had hives before?

[balancedmama]

Can you go back and identify everything she ingested in the previous 24 hours?

[Beppie]

Her hives developed before we ate dinner (which was grilled meat & zucchini). For lunch we were at a community bbq/picnic and she ate french fries --- nothing fantastic. That afternoon she had her ordinary snack, teddy graham crackers. Also some weird kind of grape juice (we thought maybe that set it off, but isn't that odd?). And she had one tiny cherry tomato from the garden. She has always eaten tomatoes in the past, and yesterday she only had a small bite. The day before (Saturday), for example, she had 3-4 cherry tomatoes from the garden. And last week she ate a burger with a tomato slice.

We were trying to think if there was anything else she ate, and we could think of nothing. She does not eat very much in general.

[lmk1]

could it be poison ivy?

[Beppie]

but we have touched her and no one else has gotten a rash.

[Huck]

also consider possibility of a contact reaction. What did she have contact with at the picnic? Any new clothing, contact with chemicals, strange plants?

something similar happened to my husband a couple of years ago... started itching uncontrollably with hives on abdomen.. went away... woke up at night with hives all over legs, arms, abdomen, back. Took a number of cold showers and a bunch of nettles in capsule form (anti-inflammatory). Didn't ever link it to food and it hasn't happened since. At the time there was a VIRUS going around, and I read somewhere that sometimes a virus can trigger hives. My husband has seasonal pollen allergies and does get hives from contact with grass.

my son also once got hives from contact with dried bean plants in the garden & ingesting 1 dried bean.

Does your daughter have any other symptoms? Nausea, fever? Has she had any previous allergic reactions?

[lmk1]

Originally Posted by Beppie

but we have touched her and no one else has gotten a rash.

I'm not sure that you would always get a rash from touching her rash, but my nephew just had poison ivy, and it started in one spot and then spread the next day...that's why I asked. There's also poison oak, sumac...
and other contact allergies. My brother had a really bad rash that the dermatologist biopsied and determined was a contact allergy, and he was on prednisone for a while before it went away. Never really knew to what.

[Beppie]

She doesn't have any other symptoms like fever, diarrhea, stomach pain, etc.

We're starting to think it's NOT a food allergy, only because it keeps coming back when the medicine wears off, and it's getting worse. Yesterday her tummy was red and swollen, now her tummy looks normal but her arms and buttocks looks red and itchy, for example. It keeps changing from place to place on her body, it's so strange! And now her shot is wearing off, and sure enough, it's popping up all over her body again.

I feel SOOOO badly for her. I wish I could do something!

[balancedmama]

Originally Posted by Beppie

She doesn't have any other symptoms like fever, diarrhea, stomach pain, etc.

We're starting to think it's NOT a food allergy, only because it keeps coming back when the medicine wears off, and it's getting worse. Yesterday her tummy was red and swollen, now her tummy looks normal but her arms and buttocks looks red and itchy, for example. It keeps changing from place to place on her body, it's so strange! And now her shot is wearing off, and sure enough, it's popping up all over her body again.

I feel SOOOO badly for her. I wish I could do something!

That is not atypical presentation for an allergy. After I took sulfa and had a reaction, it lasted for quite some time and every time the meds wore off it came back. That is because the reaction isn't getting suppressed anymore. Also hives will move from one part of the body to another, whereas a poison ivy rash (and most other contact allergens) would be in the spot of contact.

[balancedmama]

I should also add that you'll want to monitor her overnight - you may need to get another epinephrine shot if it's not being controlled by oral steroids.

[deminc]

I would change the weird grape juice drink.

I had similar hive outbreaks before - extremely itchy, raised patches, shifts and changes spot. After three emergency trips to the dermatologist, he put me on a low salicylate, chemical- free diet. He instructed me to stay on it for three weeks - so no processed food of any sort, no prepared sauces, no canned food and many more. It also covers some kinds of frits and vegetables, no citrus, no chocolate, no tofu etc.

I followed his advice doubtfully but it worked, the hives did not recur for the next five years. It is about your body's threshold level to the food chemicals. When it did recur, it was after eating my neighbour's fried chicken! Within two hours my eyes were swelled shut and I could hardly breath. We had to bundle the kids into the car screaming and crying and drive to the nearest clinic.

[Beppie]

After many of your ideas, I was starting to wonder about poison ivy, etc. But it makes sense that a contact dermatitis would be in only one place. And the most obvious thing about her rash is that it changes place. The skin on her stomach now looks perfectly fine, but her arms look like something awful, really really awful.

Hmmmm.... maybe we'll never know what is causing this. Is that the consensus?

[changingseasons]

I would think that if it's spreading to her entire body, it's from something she ingested.

I would get an appointment with an allergist ASAP, and get yourself an epipen.

I would vote that it was something she ate at the bbq. Do you know what the french fries were fried in? Has she had nuts before?

[chlobo]

What about a reaction to a bug bite?

A couple of years ago DS broke out in mysterious hives. All over his body. Luckily, it responded to benadryl. The doctor told us to see an allergist and we did but he could never determine the cause. We suspect it was either a bug bite or hives from a virus.

[Beppie]

She has eaten nuts before. Peanut butter, cashews, almonds, peanuts, etc. We don't eat nuts every day, but she has definitely never shown a sign of a nut allergy before.

I was also wondering about the bug bite. Her hives are still there (3 days later) but they are now significantly reduced from what they were on Monday. Is it possible she had a bee sting and never knew it? She never complained of any bee sting. Personally, I have never been stung by a bee and so I have no idea what it feels like... but wouldn't she notice something like that?

Another question for you all, how do you get an epipen? Do you need a doctor's prescription?

[deminc]

DS1 has been stung by a bee twice. He definitely felt them.

[sbgrace]

In my experience food related hives come up pretty quickly after ingestion and as someone else said they can certainly hang on and keep coming back even without continued exposure. I think it actually sets off a chemical reaction in the body in some way. My son's food reaction hives (and my dad's drug reaction hives) hung on and on for a discouraging amount of time. Months despite no more exposure for both of them. My mom had hives from pine nuts though and got rid of them much faster.

You do need a doctor's script for an epi pen. Some doctors are more willing to do this without a life threatening reaction than others. If she had a possible food reaction and the ER did epinepherine (what were the shots--my guess was actually steroids but someone mentioned epis?)

Most commonly hives have no identifiable cause or trigger. Many are likely viral. I'm very surprised the prednisone didn't help them more initially! When my son had a serious reaction to nuts they did prednisone in the ER and we continued it for three days though so maybe she needed continuation like that.


Zyrtec is better than benadryl for hives--both in terms of safety for repeat dosing and the fact that you don't have to constantly dose so it gives better 24 hour control. That should give her better itch control. Hives are miserable so I hope the zyrtec helps.