Posted by: Abha | 2019/05/15

Chronic urticaria not responding to Antihistaminics

I have a past history of urticaria 2 years back. Currenly I am suffering from urticaria since last 3-4 months which does not resolve with anihistamines. I also encountered angioedema on lips, face, knees, palm and neck. I am on levocetrizine and monteleukast OD, Fexofenadine 180 mg BD and hydroxyzine 25 mg HS, Rantac 150 mg BD. Urticaria aggravate with Diane 35 hence it is stopped. Food intolerance test was inconclusive still I am put on low histamine diet and Anti-TPO antibodies are way high but TSH was normal. I also have PCOS with high testosterone levels for which Diane 35 was prescribed. What should I do to prevent urticaria?

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Our expert says:
Expert ImageAllergy expert
- 2019/05/23

You sound as though you are on all the best available first stage treatments we have for Chronic Urticaria . The next step would be a "pulse" course of oral steroids reducing down over a few weeks and then possibly a trial of methotrexate, cyclosporin or Xolair but these all have side-effect drawbacks and can be very costly. It's interesting to note that thyroid antibodies are highly elevated as this raises the possibility of Hashimoto's Thyroiditis which is commonly associated with Chronic Spontaneous Urticaria (CSU) and perhaps you should see an Endocrinologist to explore this further.

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