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Abstract: Auntie Liu visited our hospital because of recurrent wind clusters with itching all over her body. After physical examination and medical history, she was diagnosed with urticaria and treated with injectable methylprednisolone sodium succinate, vitamin C injection, loratadine citrate tablets and cetirizine hydrochloride tablets, the symptoms of wind mass and itching disappeared and her condition was stable.
Basic information】Female, 58 years old
Disease Type】Urticaria (acute urticaria)
Hospital】The First Hospital of China Medical University
Date of consultation】March 2021
Treatment plan】Intravenous injection (sodium methylprednisolone succinate for injection, vitamin C injection, cimetidine injection) + oral medication (loratadine citrate tablets, cetirizine hydrochloride tablets, montelukast sodium tablets, chlorpheniramine maleate tablets) + intramuscular injection (promethazine hydrochloride injection)
Treatment period】Hospitalization 12 days, review after 3 days
Treatment effect】The disease was cured, and the symptoms of wind mass and itching disappeared.
I. Initial consultation
Aunt Liu, 58 years old, came to our hospital because of recurrent wind masses and itching all over her body. According to Auntie Liu, she suddenly and inexplicably appeared a large number of red wind masses from her abdomen 4 days ago, and the wind masses gradually spread to her limbs, which were more itchy but not painful, and became more and more itchy after scratching herself. I found that Auntie Liu was in a good mental state, her body temperature was normal, but her blood pressure was high at 150/90 mm Hg. There were a lot of red wind clusters of different sizes on her abdomen and extremities, some of which fused into a large area, with obvious congestion and edema, and visible scratch marks. The initial diagnosis was urticaria (acute urticaria), and he was admitted to the hospital for treatment.
II. Treatment process
After communicating with Auntie Liu and confirming the diagnosis with physical examination, I told Auntie Liu that the situation was not serious and there was no need to worry, and that it was mainly caused by allergy, which could be treated by using drugs alone. She was given injectable sodium methylprednisolone succinate for anti-inflammatory and anti-allergic treatment, vitamin C injection to reduce vascular permeability, and cimetidine injection, which contains skin receptor antagonists and helps to reduce skin allergic reactions. It was also treated with antihistamine loratadine citrate tablets, cetirizine hydrochloride tablets, montelukast sodium tablets, chlorpheniramine maleate tablets orally and promethazine hydrochloride injection intramuscularly. After 12 days of drug treatment, Auntie Liu was cured and could be discharged from the hospital, and was instructed to continue to take methylprednisolone tablets after discharge and to review in 3 days.
III. Treatment effect
After using the above mentioned drugs such as injectable methylprednisolone sodium succinate, vitamin C injection and cimetidine injection during hospitalization, Auntie Liu’s symptoms gradually improved, and the symptoms of wind mass and itching gradually disappeared without the appearance of new wind masses. After 12 days of hospitalization, Auntie Liu’s body temperature and blood pressure were normal, and the examination showed that all the wind masses on the abdomen and limbs had disappeared, and the skin integrity was good, with no scratch marks. 3 days later, when the review was conducted, there was no recurrence of urticaria, so it was determined that the disease was cured and the medication could be stopped.
IV. Precautions
Auntie Liu recovered well and was discharged from the hospital to recuperate at home, which is a happy thing. However, after discharge from the hospital, she needs to pay attention to rest more, forbid spicy and stimulating food, such as garlic, chili, hot pot, etc. She also needs to avoid allergenic food such as crabs and shrimps. And pay attention to avoid getting cold, to prevent cold stimulation caused by hives again, resulting in the disease does not heal. In addition, you need to take your medication at home on time to avoid adding or subtracting medication without permission, which may have a negative impact on your body. If there is any change in your condition during the course of treatment at home, you need to see a doctor at any time for treatment without waiting for 3 days.
V. Personal insight
Acute urticaria has a complex etiology, and can be caused by food, drugs, mosquito bites, etc. It mainly manifests itself as wind masses of different sizes all over the body, accompanied by itching, as in the case of 58-year-old Auntie Liu’s symptoms. Early symptoms are mild and can be treated with medication alone. However, some patients have more serious symptoms, such as respiratory distress and anaphylaxis, which require emergency medical treatment and, if necessary, surgery to open the trachea to help breathing. And if Auntie Liu has been delayed not to seek medical treatment, that is, the above-mentioned serious symptoms may appear. Therefore, do not take it lightly when the symptoms of hives appear, and treat them early.