Of note, younger children
also tend to do this from infectious illnesses, much more so than adults. This is why so many young children pick up a label of penicillin antibiotic allergy
if they develop acute hives while on a course of amoxicillin
. Only formal testing will determine whether the hives were from the infection or the antibiotic, so it is quite appropriate to label the child "allergic" until proven otherwise, for safety reasons.
Daily hives for greater than six weeks are defined as chronic hives, and are thought to be most often from an internal source, specifically an abnormal antibody
. This is typically considered autoimmune, but not all accept that label, given that most often there are no other autoimmune problems present. For a very small percentage of patients with chronic hives, lymphoma
, other malignancy, or potentially serious autoimmune disorder (i.e. Lupus) can be the real underlying cause for the hives.
Since chronic hives have to begin as acute hives, but keep going, i would advise my own patients with acute hives of unknown cause to return for re-evaluation for any of the following: persistence of hives beyond six weeks, worsening severity of hives during the first six weeks, or to report on new symptoms of concern (such as swollen lymph glands, unexplained weight loss
, night sweats
This information is of course not all inclusive, but gives the "flavor" of how a board certified allergy-immunology
specialist would approach hives. I hope you find the general risk of lymphoma to be so low there is a measure of reassurance, but this actual risk varies from person to person, so be sure to stay in communication with your primary care physician or other prescribing practioner about how you are doing with the hives and your tolerance of your medications.