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Posted 12/21/2014 3:38 AM (GMT 0)
My Daughter has broken out in a fairly severe case of what appears to be hives.

While not formally diagnosed, a nurse has told her that it appears to be hives.

She as been on Remicade and Imuran for about a year and a half now.

Does anyone think it could be medication related? Is a rash like this more than likely environmental?

The only major change I can think of lately is a change of laundry detergent.
Posted 12/21/2014 3:58 AM (GMT 0)
Hives are usually transient, ie, they come on within a few minutes, last a few minutes to 30 minutes or so, and go away.

Now, granted, if there's a bad reaction going on, then as older hives are going away, new ones can be forming, so it may appear like they're not going away.

Are they itching? With small raised white-ish areas in the middle?

Do you have any Benadryl (diphenhydramine) to give her? Benadryl usually works pretty well for hives (but it can make the person a bit drowsy).

It could be from the meds, but it could be from lots of things - like you said, laundry detergent, a food allergy, a perfume, soap, even heat or cold.
Posted 12/21/2014 4:24 AM (GMT 0)
about 2 years ago, I started getting hives on remicade. My back and arms would itch and itch and I would scratch them and they would get all raised. The first time my roommate saw it, he wanted to take me to the ER. All this skin irritation, coupled with a shortlived abscess, convinced my GI that I needed to have my blood tested for antibodies to the remicade through the prometheus test, which is a very expensive blood test that involved a nurse coming to my home. It took awhile, but insurance eventually paid for it. I forget how much it cost, but it was in the thousands. The test eventually came back negative and so I'm still on remicade to this day. I stopped having the hives reaction a while ago, but I'm not sure when that happened. I did take a lot of benadryl when it got really helped, and I also drank A LOT of wine. It just did the trick.
I was on 6mp and remicade from june 2013 to april 2014, then pregnant till November, so I don't get hives that much anymore, but my arms still really itch and I get bumps on them when I scratch them.
How old is your daughter?
Posted 12/21/2014 5:07 AM (GMT 0)
Seems doubtful that it would be med related unless she had a recent infusion, like in the last 24-48 hours. My guess would be the detergent or some other environmental factor. Hope they go away quickly!
Posted 12/23/2014 2:16 AM (GMT 0)
Been a few days now, and she's still having the hives. We showed the pharmacist tonight, and she thought it was a topical allergic reaction to something.
She said to take Benadryl for a couple of days, then if no better, we'll have to see the Doctor.
Posted 12/25/2014 5:23 AM (GMT 0)
Starting to get worried now. Has been on Benedryl for a few days now, and it doesn't seem to being helping at all.

Tonight, she started complaining about her throat feeling swollen. Tomorrow's Christmas Day, so no hope of getting to the Doctor, and really don't want to opt for Emergency considering the current flu outbreak here.

The only major changes we could think of are the laundry detergent, and a Christmas tree.

Also, really worried that it has something to do with her Remicade. She's been on it now for almost 2yrs.

Any advice or insight would be greatly appreciated.
Posted 12/25/2014 5:43 AM (GMT 0)
If - and that's a big if - her throat does swell to the point it affects her breathing at all, go to the ER. Even if it's Christmas day.

Can you use a flashlight and check the epiglottis and soft palate, along with looking at the back of the throat for any signs of swelling?

When was her last infusion of Remicade?

If it were an allergic reaction to the new laundry detergent, I would expect it to be more intense in areas where clothing is close to the skin, and less intense elsewhere. I would also expect something like a shower and benadryl to help. And I wouldn't think it would affect her throat.

Similar thoughts about the Christmas tree not being the culprit. I would expect runny nose or watery eyes or itchy skin as possible reactions, but what you're describing seems like more than that.

I do share your concern that it could be Remicade. Let her GI's office know on Friday if it's still happening. A medrol dosepak (quick steroid burst) might be in order.

She might also need to see an allergy specialist for some testing, but the bad news is that they don't always figure out what the cause is.
Posted 12/25/2014 1:34 PM (GMT 0)
Thanks Beave,

She's not up yet, and I've been up most of the night. I'll check her throat as you suggested.

I wouldn't be as concerned if it's an allergic reaction to something topical, like the detergent. The hives are mostly her torso, nothing on her arms or legs. I know the Christmas tree sounds like a long shot, but there's reactions all over the internet as store bought trees are now being sprayed with a chemical to preserve them longer.

My big fear is anti-bodies to Remicade. She's been doing so well Crohn's wise for the last 2 years. It would be awful if it's that. Her last infusion was 6 weeks ago.
Posted 12/27/2014 12:52 PM (GMT 0)
Merry Christmas,

How is your daughter? She needs a short burst of steroids with the benadryl no matter whats causing them. Does she have steroids and benedryl before every infusion? I did, thats why I asked. Keep us posted.

Julia
Posted 12/28/2014 1:09 AM (GMT 0)
I was on Imuran and Remicade for about two years and would get hives regularly while on it. My doctor eventually gave me Benadryl with each infusion. It seemed to help. I would at least get checked by the doctor and see what they think. Good luck.
Posted 12/28/2014 1:58 AM (GMT 0)
Julia/FeelingSunny,

Thanks guys for your concern. It's been several days, and she's still the same, no better or worse.

She does get premeds with every infusion. She's 6 weeks post infusion now, and has never had any kind of reaction during or otherwise.

We took the Christmas tree down yesterday, (felt like a real Scrooge), and we switched back to our usual laundry detergent.

If the cause is one of those things, how long should it take for the hives to resolve?

She also did take benedryl, but only a couple of doses. Didn't seem to help. Should she maybe take it for a couple of days every 6 hours?
Posted 12/28/2014 2:08 AM (GMT 0)
Yes, I would suggest taking it every six hours for a couple of days. Depending on her size, maybe 50mg every 6 hours (two tablets instead of one). I forget her age - is she old enough to drive? I wouldn't let her drive or do anything like that while she's on it, because it can make you a bit drowsy.

If it's just the laundry detergent, it should be quick, as in a shower and change of clothes should show improvement. If it's the tree, it could take a while, at least a few days I would think.

I do suggest you bring it up to a doctor on Monday, or at the very least take pictures of the hives so that the doctor can see what was happening when you have your next appointment.
Posted 12/28/2014 3:55 PM (GMT 0)
Thanks again Beave,

Your take on it certainly seems reasonable. Will call the Doctor tomorrow.

Hopefully the next update I have is positive.

Tom.
Posted 12/28/2014 11:25 PM (GMT 0)
Hey Tom, just wanted to throw this out there in case it is the detergent. I had a reaction to a new detergent, only on my torso and it stayed red and itchy for over a week. When I finally figured out what it was, I needed a course of steroids to get rid of it completely. Benadryl did nothing to help.

Hives are usually itchy bumps that come and go. Are hers coming and going? Or is It a rash like an allergic reaction?

Hope you can get it resolved soon! I'm sure she's uncomfortable!
Posted 12/29/2014 1:26 AM (GMT 0)
Hi Stef,

She's very similar to what you're describing, but it doesn't seem to come and go. The classic red bumps seem to stay and are mostly on her abdomen and back.

They are itchy, and are quite a nuisance. She feels totally fine otherwise.

Also as you describe, the benedryl did nothing so far. Hopefully get in to see the Doctor this week. Thanks very much for replying.

Tom
Posted 12/29/2014 9:39 PM (GMT 0)
Hey 73monte...this sounds like something I had three times now.  Pityriasis.  You are only supposed to get it once in a lifetime---and when you are young (I am counting when I got it in my 30s as still being young then!)

It starts with one red patch usually on the chest sometimes on the lower back or belly.  It then spreads to the torso only--occasionally the upper thighs or shoulders.  I thought they looked like big mosquito bites I get.  Benadryl did not help me except maybe it reduced the itching????  I was told to use OTC corticosteroid cream---which really only made my clothes have greasy marks.  Mostly I had to wait it out.

I have also had something called fifth disease (another childhood disease I ahve had at 12 and 35!)which looked similar but spread to my legs as well.  I am the land of wacky skin issues it seems :-)

Finally, I am allergic to pine tree needle pricks, but not just having it in the room so I am doubtful this is that.

I would take pics of the welts now but get in to see a doc just in case.  Ask about pityriasis and fifth disease.

 

Posted 12/29/2014 11:17 PM (GMT 0)
Hi HabsHockeyFan,

I can't believe how ironic your reply is!!!

I was able to get my Daughter in to see a Doctor today. Our Doctor is away, so we were referred to on of the other Doctors at the Medical center we go to.

After examining her, she concluded that it is in fact Pityriasis Rosea.

She said she only sees about 2 cases a year, very rare. It's viral, so really no treatment other than for symptoms. She prescribed an antihistamine.

Thanks very much for taking the time to reply. Shows how valuable this forum is.

Tom.
Posted 12/29/2014 11:40 PM (GMT 0)
That's awesome - great that they figured it out, great that it's not a reaction to Remicade (so she can keep taking it), and great that Habs figured it out!

HabsHockeyFan, nice work!
Posted 12/30/2014 2:12 AM (GMT 0)
Thanks Beave,

Maybe I should refer to her as Dr. Habs from now on.

I too am very glad that this is viral, and nothing to do with a Remicade reaction.

Only other thing, she was also going to get a flu shot today, but thought, (and the Dr. agreed), that better wait until this resolves.

Tom.
Posted 12/30/2014 12:38 PM (GMT 0)
Hey 73monte...I'm not a doctor, but I did stay at a Holiday Inn last week...oh wait that was a Sheraton! tongue

I love when the odd things can be shared so we are all a little less alone in this.  Hope things are getting better every day now!

Posted 12/30/2014 9:55 PM (GMT 0)
Thanks Habs,

I know you're not a Doctor, but I hope you don't mind if I consult you first regarding our next off beat ailment. I've got alot of confidence in you now.

Tom.
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