Sep 2012|Vol 9|Iss 9

   
 
Case
 
   
A case of acute Urticaria
 

 

Dr. Jayashree Nanda. M.D. (hom)
Faculty in Dept. of F.M.T
Dr. Abhin Chandra Homoeopathic Medical College & Hospital
Unit III, Bhubaneswar, Odisha.
Mobile 09937689878
E mail : jayashree30@hotmail.com

 
 
 

         A girl aged 18 years, one day had taken some cheese in her lunch at 3pm. After 1hour she felt some discomfort in her abdomen with itching in whole body and mild breathlessness. The sequences are given below with the treatment.

4pm

       Abdominal spasm, nausea, followed by vomiting of food eaten. Then itching of some parts of body followed by small eruptions. Presence of little thirst. The patient is restless and full of anxiety with breathlessness. She had experienced such types of reactions earlier after taking prawn, egg etc. Arsenic alb 30 one dose was given.

5pm

       There is no vomiting, only nausea associated with severe abdominal cramps, which lasts for ten minutes and stopped. Itching of whole body with eruptions of increasing size continued. More the itching more the chilliness felt with hot flushing from the body. Ars 200 one dose was given, waited for 30 minutes but no improvement marked.

6pm

       All the complaints were same .Gradually it was marked that when there was severe spasm with nausea in abdomen there was no itching. Pulsatilla 200 was given, due to spasm in abdomen and itching of whole body alternate, more the pain and itching more the chilliness internally but the patient needed open air due to suffocation, no thirst and evening aggravation.

7pm

       No improvement marked. Gradually the internal chilliness disappeared. There is hot flushing from the body due to severe itching and red urticarial eruptions & the patient needs cool air to get relief. Itching of whole body was continued, the small eruptions coalesces and big urticarial (angioneurotic oedema) eruptions were formed. Stinging pain in whole body. There was no thirst. Apis mel 200, one dose was given. Surprisingly within 20 t030 minutes the hands had taken rest, the patient became sleepy after great exhaustion. The abdominal spasm diminished. Towards 9pm the size of the eruptions gradually started to diminish. At 11pm the urticarias gradually disappeared & to the next morning there was normal skin.

       Gastrointestinal anaphylaxis is a Type 1 hypersensitivity reaction. The sequences of events of Type1 hypersensitivity reactions are, first the antigen is introduced in the host’s body for the first time in life, no hypersensitivity reactions occur. After a few weeks, a second dose of same antigen is repeated, hypersensitivity reactions occur. The reactions clinically may be anaphylactic shock, urticaria, and so on.

       The allergen introduced for the first time begins to produce IgE antibodies which attach to the surface of mast cells and basophils forming a complex. Next time when another dose of antigen is given, the antigen binds with these complex and degranulation of mast cells or basophils takes place causing release of histamine, prostaglandine, leukotrienes etc. Histamines produce vasodilatation and bronchospasm. When histamine release is small they produce merely local reactions like urticaria. But when massive amount is released there is massive vasodilatation producing sharp fall of blood pressure and severe bronchospasm, which is called anaphylactic shock. For gastrointestinal anaphylaxis some type foods produce such types of reactions with diarrhea and vomiting.