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Abstract: Acute urticaria is a type of urticaria characterized by rapid onset. A 15-year-old girl came to our hospital with symptoms of red bumps all over her body, accompanied by itching, abdominal pain and sore throat.
Basic information】Female, 15 years old
Disease Type】Urticaria (acute urticaria)
Hospital】The First Hospital of China Medical University
Date of consultation】January 2021
Treatment plan】Intravenous injection (sodium methylprednisolone succinate for injection, vitamin C injection, calcium gluconate injection, cimetidine injection) + intramuscular injection (promethazine hydrochloride injection) + oral medication (cetirizine hydrochloride tablets, chlorpheniramine maleate tablets, cold and flu granules, oseltamivir phosphate capsules, methylprednisolone tablets) + topical medication (glyburide lotion)
Treatment period】6 days of hospitalization and follow-up after 3 days
Effectiveness of treatment】The symptoms of wind mass, itching, abdominal pain, and throat pain disappeared, and the disease recovered.
I. Initial consultation
A 15-year-old girl was admitted to the hospital with a red and itchy wind mass all over her body. The girl reported that she had started to develop wind masses with itching, abdominal pain, nausea, vomiting and chest tightness 3 days ago, and had started to experience pain in her throat 2 days ago. On examination, I found that the girl’s temperature and blood pressure were normal, but wind clusters of different sizes were visible all over her body, some of which were fused together into a large irregular map shape, with scratch marks and blood crusts in some places. There was pressure pain around the belly button in the abdomen, but no mass was palpated. The mucous membrane of the pharynx was congested, but the tonsils were not enlarged, accompanied by bilateral eyelid edema.
II. Treatment history
After confirming the diagnosis through physical examination and clinical manifestations, I gave intravenous injection of sodium methylprednisolone succinate for anti-inflammatory and anti-allergic treatment, vitamin C injection and calcium gluconate injection for desensitization and vascular densification treatment, and cimetidine injection to supplement the efficacy of anti-allergic drugs. Cetirizine hydrochloride tablets and chlorpheniramine maleate tablets were given orally and promethazine hydrochloride injection was given intramuscularly for antihistamine treatment. Due to the severity of the itching in the girl, topical application of glyburide lotion was given to help relieve the itching. Oxygen was also administered. As fever appeared on the second day of hospitalization, she was treated with cold and flu granules and oseltamivir phosphate capsules, which were more effective. After 6 days of hospitalization, the girl recovered well and was discharged from the hospital with methylprednisolone tablets, and followed up with the hospital 3 days later.
III. Treatment effect
Before the girl was hospitalized for treatment, she showed symptoms of red bumps all over the body with itching, abdominal pain, nausea, vomiting, chest tightness and sore throat. After 6 days of treatment, she was examined: the wind masses subsided and no new wind masses appeared on the whole body, the skin integrity was good, and the symptoms of pharyngeal congestion and bilateral eyelid edema disappeared. The girl reported no recurrence of symptoms at the follow-up visit 3 days later, and was discharged from the hospital with instructions to stop the medication.
IV. Notes
I was happy to see that the girl’s condition gradually recovered and she could be discharged from the hospital. However, in order for her condition to recover better and not to recur, I still need to tell her to stay away from allergens when she goes home. She should avoid eating foods that can cause allergies, such as sea fish, shrimp, crabs, etc. She should also avoid eating spicy and irritating foods, such as hot pot and spicy hotpot, to avoid stimulating her condition and causing her to relapse. In addition, you need to adhere to the medication after returning home, and not to stop it on your own. If symptoms such as wind mass and itching appear again during the treatment at home, you need to seek medical treatment in time.
V. Personal insight
Clinically, urticaria can occur at all ages, such as in this case of a 15-year-old girl with acute urticaria. The effects of urticaria on the body and daily life are more obvious, such as the symptoms of wind and itching can affect the patient’s spirit and sleep, and in severe cases, can lead to changes in appearance and cause low self-esteem. Therefore, after the condition has stabilized, you need to pay attention to stay away from risk factors that can trigger urticaria attacks, such as cold air, ultraviolet light, pollen, dust, etc.