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Young man who would develop severe #itching over body after #running
1. 33-year old Sid presented with an unusual symptom. He used to develop severe itching all over body whenever he ran 4 km or more. He had been unsuccessful in his attempt to train for long distance running.
1. 33-year old Sid presented with an unusual symptom. He used to develop severe itching all over body whenever he ran 4 km or more. He had been unsuccessful in his attempt to train for long distance running.
2. He had no itching when at rest. He had no allergy to any food items. There was no other comorbid illness. In all, he was healthy, however, due to his inability to run (or do any other high-intensity exercise, he was gaining weight, and had gained 10 kg over the past 2 years).
3. Sid was quite troubled by his inability to run (which he badly wanted to do). He had consulted a few local physicians, who could not offer any significant help. At this time, one of his friends (who knew about my passion for running) suggested that he consult me.
#MedTwitter
#MedTwitter
⭐️FIVE Little Allergy/Immunology Lessons from 5 Big Days on Consults ⭐️ @mghaifellows @MGHAllergy. #Urticaria #Angioedema #vaccine reactions eosinophilia and #drugallergy /1
ONE-To treat acute urticaria (hives), antihistamines should be nonsedating and scheduled (not diphenhydramine PRN). Allegra/fexofenadine and Zyrtec/cetirizine have large therapeutic windows and are used safely at 4+ times the daily allergic rhinitis dose/2 
TWO-Angioedema in an adult without skin itching/hives/rash—check if they on an ACE inhibitor! Although ~10% get it w/in 30d, many happen after years of uneventfully being on it /3 ncbi.nlm.nih.gov/pmc/articles/P…
