Search
× Search

Urticaria (Hives)/Angioedema (Tissue Swelling)

Urticaria (Hives)/Angioedema (Tissue Swelling)

Most “hives” are caused by histamine and other mediators “released” in the upper layers of the skin.

Histamine can be released from special cells, mast cells and basophils, which are found in everyone’s skin.

Patients with hives release “too much” histamine when it is not needed and are classified as:

  • “Acute hivers” only when they take in an identifiable “trigger”, i.e., drug, food, etc. or if hives last less than 6 weeks.
  • “Chronic hivers” daily or almost daily without an identifiable “trigger” and lasting for greater than six weeks.

In “chronic” urticaria or persistent hives, a “trigger” is rarely found. A “complete” history is needed to look for identifiable “triggers”.

The etiology for chronic urticaria such as medication, heat, pressure or infection is found in less than 5% of patients.

For most cases of chronic urticaria the etiology will remain idiopathic (cause unknown) although an autoimmune etiology can sometimes be found.

  • Angioedema (tissue swelling), occurs in 90% of patients with chronic urticaria

For chronic urticaria laboratory evaluation can be performed: Thyroid auto-antibody profile, CU Index, complete metabolic profile, complete blood count and autoimmunity tests.

Fortunately, most chronic hives go away with or without treatment:

  • 50% of patients hives go away in 3-12 months
  • 20% of patients hives go away in 12-36 months
  • 20% of patients hives go away in 36-60 months
  • 1.5% of patients can have hives for up to 25 years

60% of “chronic” hivers have recurrences of the hives

Management is directed toward keeping patients “comfortable” with or without some hives being present. This can be achieved with “appropriate” antihistamine therapy, and occasionally with “other” medications. Prednisone (steroid) should be avoided if at all possible.

Remember the potency of:

  • Benadryl 50mg. is considered — a strength of 1
  • Clarinex, Claritin, Allegra — a strength of 2-3
  • Atarax (hydroxyzine 25mg.), Zyrtec, Xyzal — a strength of 88
  • Doxepin (Sinequan) 25mg — a strength of 779

 

Recent News

SuperUser Account
/ Categories: News

Needle-Free Option for Severe Allergic Reactions Expanded for Use in Children

Doctors at the Oklahoma Allergy and Asthma Clinic call the FDA approval a game-changer

Parents now have a needle-free, life-saving option should their child experience a severe allergic reaction.

The U.S. Food and Drug Administration this week approved neffy nasal spray in a one milligram dose, expanding its use to younger children. Neffy is a nasal spray for the emergency treatment of severe allergic reactions, including anaphylaxis. The FDA action means neffy may now be used in children ages four years or older, weighing between 33 and 66 pounds.

The drug was originally approved as a two-milligram dose for individuals over 66 pounds back in August of 2024.

“The approval of one milligram neffy is a game-changer for our young patients who suffer from severe allergies and asthma-related anaphylaxis,” said Dr. Maya Gharfeh, allergy and asthma specialist at the Oklahoma Allergy & Asthma Clinic. “As a physician, I’ve seen firsthand the hesitation and fear that children and parents experience when faced with the need for an epinephrine injection. With neffy, we now have a needle-free alternative that can provide the same life-saving benefits in a less intimidating way.”

Neffy provides a convenient and effective solution for managing life-threatening allergic reactions without the need for injections.

“Anaphylaxis is life-threatening, and some people, particularly children, may delay or avoid treatment due to fear of injections,” said Dr. Kelly Stone, Associate Director of the Division of Pulmonology, Allergy, and Critical Care at the FDA’s Center for Drug Evaluation and Research. “The availability of epinephrine nasal spray may reduce barriers to rapid treatment of anaphylaxis.”

According to the the Asthma and Allergy Foundation of America, anaphylaxis occurs in about one in 50 Americans and some estimates place it as high as one in 20.

“As allergy specialists, we know that some parents of small children may hesitate to use traditional epinephrine auto-injectors due to needle anxiety. Now, we have another option for them,” Gharfeh added.

Neffy is expected to be available in the United States by the end of May 2025.

For more information about the Oklahoma Allergy & Asthma Clinic, visit at www.oklahomaallergy.com or for an appointment, call 405-235-0040.

The post Needle-Free Option for Severe Allergic Reactions Expanded for Use in Children appeared first on Oklahoma Allergy and Asthma Clinic.

Previous Article Not a Cold. Not the Flu. It’s Cedar Fever! Who Knew?
Next Article Important Recall Notice for AIRSUPRA Inhalation Aerosol
Print
60
Terms Of UsePrivacy StatementCopyright 2026 by Oklahoma Allergy and Asthma Clinic
Back To Top