timeframe for an IgE(?) reaction?

[onetrumpeter]

DS had a good amount of trout my dad caught in a lake. That was last night, Friday night, around 7:30pm. He's had salmon and tilapia (at least) and has never had a reaction that I've seen. I figured "fish" in general were safe for us. This am, around 7:30 am he woke up with a rash all over his body - mostly blotchy, very slightly raised. I quickly ruled out reaction since I figured he's been fine with all other fish. He's had a cold/virus/nasal congestion and cough so I wondered if the rash could be a viral thing. Demeanor was totally normal - wanted to play, was happy, etc.

But we drove back home from camping JIC and to get cell signal to call peds. They rec'd benedryl and said it sounded like hives. Said to watch for respiratory issues. He got benedryl at 10:45am. RFing in backseat, and fell asleep (I guessed from the benedryl). When we got home around 1:00 his face looked a lot clearer, but the rash was still all over his body.

I was thinking it was clearing but since it was still all over his body (though I'm not sure if it diminished somewhat as in the cold tent this am I didn't get a thorough/great look) that it probably wasn't an allergic reaction.

Then this afternoon around 4:00 it was becoming more pronounced. By bedtime just now, it was definitely back on his face and his body maybe even seemed more red. Sooooo, I'm guessing this is a reaction, likely to the trout as nothing else was new in his diet.

I'm watching him closely on the monitor. He's had 4.5 mL of children's benedryl... I may try to give him more during the night but how long might a reaction last? Could the reaction get worse from here? Almost 24 hrs after ingestion? How long for an allergen to clear his system? Help a trying-not-to-freak-out mama!

[True Blue]

Funny you ask this! I ate brussels sprouts for the first time Thursday night, and I'm jumping out my skin itchy all over with hives, even with benadryl. Yes, it can be delayed up to 24 hours, and yes, it can keep going. When I reacted to antibiotics as a teen, it took WEEKS and finally steroids for my hives to stop coming. When DS reacted to antibiotics, he had hives for a good week too. I'm so sorry. It sucks, and I am so not having fun being itchy, either. I feel for the poor guy.

[onetrumpeter]

Wow, Amy, thanks for sharing. Sorry you're dealing w/ a brussels sprouts reaction. Weird! Never heard of that, but obviously you can react to anything.

The weird thing is that they don't really seem very itchy to him... he was sort of scratching at his arm a bit during storytime but that was after I was feeling his arm to check how raised they were feeling there. I'm thankful, but that was another weird thing of figuring out what the rash was. I think his hands and feet, and maybe even face were puffy before bedtime. But since he did respond to the benedryl (or that's what I'm guessing) I don't feel a need to visit the ER yet. I think breathing's the big thing I should be looking for, right?

Good to know that it can last so long; I really hope ours fade soon and his little body can get back to normal...

[JaneS]

I hate to say it but a lot of lakes are contaminated, I'd wonder if that was it. For example, our state specifically says for women and children not to eat fresh water fish
http://www.mass.gov/Eeohhs2/docs/dph...ory_poster.pdf

[onetrumpeter]

hmmmm, JaneS. Interesting. I did wonder about the origins of the fish. I know they stock the lake, and I presume from fish hatcheries, and I'm sure those fish are given a nice, healthy diet of corn (LOL!). So not a healthy fish, but I figured, compared to our hot dogs from the grocery store, it probably wouldn't be worse... but maybe it was. I'm not 100% certain this is hives/allergic reaction. I just checked him. He's sleeping well, and seems pretty comfortable, but his back is sooooo rashy/hivey. There's very little normal looking skin I don't know how he's comfortable. He had a second dose of benedryl at 6:30pm. I definitely noticed his face clearing a bit after this first dose in the am, but it's hard to see that there's been an effect from this most recent dose of benedryl (now more than 3 hrs later). I hope we can all sleep tonight (ok, I hope I can not worry...). I found this http://www.askdrsears.com/html/8/t082400.asp and am trying to focus on this

When to go to the ER: Because this is an allergic reaction, you need to observe your child for other signs of a severe allergic reaction such as throat tightness, wheezing, breathing difficulty, extreme weakness or lightheadedness, significantly pale, or persistent vomiting. Go to the ER if these happen. When to call your doctor's office for an immediate appointment: If none of the above signs of a severe allergic reaction occur, but your child has swelling of the hands, feet, or face, or the hives are all over the body, and they don't improve within 2 hours after Benadryl, see your doctor right away. If it's the weekend or after hours, go to the ER.

but of course like I said, I'm not 100% certain it's an allergic reaction. But he does seem pretty comfortable and even with his virus/cold/nasal congestion/cough so I don't think it's a viral rash... And we had some improvement from the benedryl earlier, I think. Praying for wisdom to determine if an ER visit is remotely warranted.

OK - sort of thinking through it here. Thanks for the thoughts, ladies.

[onetrumpeter]

want to update while I can recall:

Sun am. he woke and had a fever. Was pretty uncomfortable, itchy, and hands, feet, and face def puffy. Called ped; she rec'd ER.

ER nurses were quick to ask "is he having an allergic reaction?" and when DH said we think so, they got him seen quickly. NP there pondered "scalded skin," and brought in another NP to see his "spectacular rash." Praise the Lord, DS was feeling better (maybe we'd done another dose of benedryl) and was loving the attention and doing really well. MD's dx was erythema multiforme major (minor would be afebrile).

Follow up appt w/ ped on Monday, he'd woken with quite a puffy face, hands, and feet. Got seen in the morning; doctor brought in another doctor; said he has angio edema and looks like allergic reaction. She consulted with an allergist who said to do prednisone (2x/day for 5 days) to curb the cascade of histamine response. We're doing that and had a follow up to the follow up today lol. He was looking great; fever's been gone (allergist said a hives reaction can cause fever, IIRC) and his skin was looking really clear.

Get home from doc appt and go vote; playing outside at the school playground, I notice his face is starting to look rather hive-y.

Hive-y face is increasing; I called peds and asked should we do his prednisone dose earlier than 12 hrs since the previous. His whole body was becoming hive-y again. It seemed like his hands and feet were becoming more puffy again. He was itching like crazy even though he'd had benedryl three hours prior. They said yes to the early 2nd dose of prednisone. The hives really started fading. Sleep has gone well so far - he seems comfortable.

Praying he'll clear through this reaction. Stumped as to what it's to. Ped said could be trout/fish (though she felt that was a slim chance); said hives could also be from a virus and cause elevated histamine which was causing the angio edema, too.

Oh, boy, mamas, I really feel for you that deal with these hive-y (IgE?) reactions. SO thankful we've not had respiratory issues.