Most people who have chronic urticaria (hives) complain of severe itching. Chronic urticaria or chronic hives is associated with welts with or without swelling that generally resolve within 24 hours. It is considered chronic if it lasts 6 weeks or longer. Another term used is chronic spontaneous urticaria or chronic idiopathic urticaria. An estimated 80-90% of patients with chronic hives have no identifiable cause of the disease. It has been associated that some patients with chronic urticaria have other systemic complaints during active wheal flares. These include gastrointestinal symptoms, flushing, joint pain or swelling, cardiovascular manifestations, respiratory symptoms and other constitutional complaints.
A recent study published in the Sep/Oct 2017 issue of The Journal of Allergy and Clinical Immunology; In Practice, analyzed the systemic complaints in chronic urticaria. A total of 155 patients with chronic idiopathic urticaria were surveyed. 103 of them reported systemic complaints.
- 55.3% had joint pain or swelling
- 47.6% headache/fatigue
- 42.7% flushing
- 30.1% wheezing
- 26.2% gastrointestinal complaints
- 9.7% palpitations
The authors of the study noted that the fatigue could be noted to sleep disturbances. Patients with chronic hives report frequent sleep awakenings and difficulty falling asleep, with daytime fatigue reported by 75% of the patients.
Chronic urticaria significantly affects quality of life, limits the capacity to work and leads to a higher prevalence of health care use. Patients with systemic complaints have a greater use of corticosteroids, ER visits and more work/school absences.
It is important to assess all patients with chronic hives and all the complaints that they have. The treatment for chronic urticaria can be seen in the accompanied link.
Many patients with recalcitrant hives have been seeing a strong benefit with Xolair which initially came out for severe asthma.
Recent data on patients with chronic hives have come out, helping to explain the cause and best treatment options.
If you are suffering from chronic hives (urticaria), see a board certified allergist/allergy doctor about what treatment options are best for you.