What you describe suggests that you are a highly atopic (allergic) person and you may well be allergic to your terriers. It is not always possible to diagnose the immediate cause(s) of a flare-up of hives but the best way is for you to prepare a very detailed inventory of all your exposures to potential allergens, (inhaled, ingested or by physical contact) and work closely with a good allergist. When the cause cannot be identified, one must resort to treatment with antihistamines and corticosteroids. More recently, there have been reports of the treatment of auto-immune urticaria with a monoclonal antibody, Omalizumab. The following may be of interest to you and you may want to share it with your allergist.
Authors Full Name Kaplan, Allen P. Joseph, Kusumam. Maykut, Robert J. Geba, Gregory P. Zeldin, Robert K.
Institution National Allergy, Asthma, and Urticaria Centers of Charleston, Charleston, SC, USA. ***@****
Title Treatment of chronic autoimmune urticaria with omalizumab.
Source Journal of Allergy & Clinical Immunology. 122(3):569-73, 2008 Sep.
Abstract BACKGROUND: Approximately 45% of patients with chronic urticaria have an IgG autoantibody directed to the alpha-subunit of the high-affinity IgE receptor (chronic autoimmune urticaria, CAU) leading to cutaneous mast cell and basophil activation. Treatment of allergic asthma with omalizumab produces rapid reduction in free IgE levels and subsequent decrease in Fc epsilon RI expression on mast cells and basophils. If this occurs in CAU, cross-linking of IgE receptors by autoantibody would be less likely, reducing cell activation and urticaria/angioedema. OBJECTIVE: To investigate the efficacy of omalizumab in patients with CAU symptomatic despite antihistamine therapy. METHODS: Twelve patients with CAU, identified by basophil histamine release assay and autologous skin test, with persistent symptoms for at least 6 weeks despite antihistamines, were treated with placebo for 4 weeks followed by omalizumab (>or=0.016 mg/kg/IU mL(-1) IgE per month) every 2 or 4 weeks for 16 weeks. Primary efficacy variable was change from baseline to the final 4 weeks of omalizumab treatment in mean Urticaria Activity Score (UAS, 0-9 scale). Changes in rescue medication use and quality of life were assessed. RESULTS: Mean UAS declined significantly from baseline to the final 4 weeks of omalizumab treatment (7.50 +/- 1.78 to 2.66 +/- 3.31, -4.84 +/- 2.86, P = .0002). Seven patients achieved complete symptom resolution. In 4 patients, mean UAS decreased, but urticaria persisted. One patient did not respond. Rescue medication use was reduced significantly, and quality of life improved. No adverse effects were reported or observed. CONCLUSION: This exploratory proof of concept study suggests omalizumab is an effective therapy for CAU resistant to antihistamines.
Good luck
thank you! I have an appt in the morning.
Also, I had the shingles in March/April of this year...right around when the hives started getting REALLY bad. I don't have HIV, but I do have hypothyroidism which was just tested as normal two weeks ago.