Hives

[Genlando]

About a week ago, I started feeling a severe itching sensation all over my body while I was at my dialysis.  I scratched and scratched for the whole time I was on the machine.  I thought that I must've had too much phosphorus in my diet, so I asked for some benadryl.  This had no effect.  One of the techs waited until I was coming off the machine before she told me that I should probably go to the emergency room.  I asked her why, and she said: "Go look at yourself in the mirror, and you'll know why."  I went into the restroom, and saw that I was completely covered in hives!  I'm especially pissed, because none of the nurses or techs noticed that my pecan-tan skin had turned bright red during the 4 and a half hours that I was connected to the machine.

Any rate, I went to the emergency room, and they said that since my throat wasn't closed up, that I wasn't in immediate danger.   They told me to continue taking benadryl, and come back if the hives didn't clear up within 48 hours.  That was Thursday afternoon. 

The hives didn't go away by Saturday.  Even though I was taking benadryl and Allegra, and also covering my body with benadryl gel, the hives actually got worse.  I therefore went back to the emergency room Saturday morning.  This meant that I missed my Saturday dialysis treatment. 

The ER doctor gave me a Prednisone shot, and prescribed a course of oral steroid medicines--in addition to another antihistimine.   Even with these industrial-strength meds, the hives didn't completely clear up for about 5 days.

I am admittedly sensitive to all kinds of allergens--including bananas and watermelon (yes, I'm a black guy from the South who's allergic to watermelon--go ahead and joke away).  However, I haven't recently been exposed to anything that I normally react to.  No changes in soap, laundry detergent, fabric softener, etc.  No new foods or different restaurants. 

Here's my question:  Has anyone heard of dialysis causing hives? I didn't start itching until I was put on my machine, and the itching seemed reached a crescendo towards the end of my treatment.  I asked the people at my center whether they'd ever heard of this, and naturally, they all said they hadn't.  I'm an inherently un-trusting person--especially when dealing with my dialysis center--so I really don't believe them.

My center has recently had several RN's leave, so we've got a number of nurses coming from different centers from all over the area.  I don't know whether that could have anything to do with it. 

[Tracy]

Not sure if this would have anything to do with it, but at my center, they have to run a full bag of saline through the machine before I can get hooked on.  The filter caused me to have severe headaches.  Not itching, but distress still the same.  I wonder if maybe they should do that to your machine before you get hooked on.  Maybe the filter or something in the lines are making you itch?  I don't know.  Just a thought.

Good Luck! 

[KICKSTART]

I wish i could help ! How long have you been doing D ? if its been a while then i doubt its anything to do with that . What exactly is Hives? ..an allergic rash ?  If you have only just started doing D then it could be so many things from fluids used, to meds ,the list would be endless. All you can do is see if it triggers again , maybe you have developed a new sensitivity to something ?

[greg10]

About a week ago, I started feeling a severe itching sensation all over my body while I was at my dialysis. ...

Here's my question:  Has anyone heard of dialysis causing hives? I didn't start itching until I was put on my machine, and the itching seemed reached a crescendo towards the end of my treatment.  I asked the people at my center whether they'd ever heard of this, and naturally, they all said they hadn't.  I'm an inherently un-trusting person--especially when dealing with my dialysis center--so I really don't believe them.
.

You really should ask your center if they have changed any medication and supplies such as heparin suppliers/dosage, cartridges, tubings.  Even epoetin can cause allergic reactions.

The following is from an older post from another forum from a person with the same problem.   With some changes in the heparin supplier and changed to epoetin subcutaneous injections, this person was able to avoid episodes of hives after dialysis.

m micone
         Posted 28 October 2001 01:18 PM    

I just experienced an episode of terrible itching that happened over a period of a month. I have been on dialysis for 4 1/2 yrs, so any new effects get my attention. My itching came as an attack of hives, one to two hours after dialysis. The hives were maddening. I took Benadryl as a short term cure, but its such an obnoxious drug, with so many side effects that I was motivated to find the REASON I was itching. Most medical changes are cause and effect. I have deduced through trial and error that the itching and the hives were caused by two different elements. First, general itching, in legs, arms, back seems to be due to takng off too much fluid. Because its brief and can be allayed by a good moisturizer, this low fluid weight casue seemed to be the culprit. Many accuse high Phos, but wether mine is high or low doesn't seem to correlate to the itching. In the past two weeks I've worked with the techs to hit an exact dry weight, each treatment, and have had no further itching.
The HIVES, curticaria, were tougher to diagnose a cause. I'm not allergic to anything in particular. I'm on single use. Nothing in my treatment has changed dramatically except the use of Zemplar. I researched all manner of info to find a cause. My supposition was it might be the epo. But in a brief discussion with my Neph, he supposed that the pork Heparin might be it.
Normally I would have scientifically changed out one suspected drug at a time to find the culprit, but the hives were so bad that I made the following changes simultaneously - change from pork to beef heparin, and change from intravenous epo to subcutaneous epo. I have not had an episode of hives since these changes were instituted. I suspect that the heparin was the culprit. It seems that over the 4 1/2 yrs on dialysis I slowly developed sensitivity that triggered a reaction. Hope some of these insights are of help.

[Genlando]

Thanks for the insights thus far, everybody. I've been on dialysis for about 6 months so far.  Interestingly, I've not had a relapse of the hives since I had the one recently.

My hemoglobin has been optimal for the last couple of months, so I haven't needed to get any epogen. 

I just thought of something that was different, however: I had a new catheter placed a week before (I've got a post somewhere talking about a fistulagram, and they moved my catheter to the other side of my chest).  I had received on D treatment on the new catheter (no heparin, since I'm on coumadin), and then I had the hives after that.  Maybe there was an interaction between the heparin and the new catheter.

Or, maybe this is just going to be one of those mysterious allergic reactions that spring up just once, and never come back again...let's hope so!

[RightSide]

Yep, in my dialysis center we've had a number of severe allergic reactions.  It can be from the heparin, or from the dialyzer (artificial kidney), or even from the disinfectant they use to clean the dialysis chairs.

Now when you get a severe allergic reaction like hives, it may continue to linger (or come and go) for months, until your immune system gets "tired" of reacting to the offending substance.  When I developed hives from Ceftin (an antibiotic), for six weeks thereafter, the hives kept coming and going, even with antihistamine treatment. Eventually they stopped.

So be patient.
That's why they call us "patients".   

[kitkatz]

Have they changed the dialyzers in the clinic.  I turned out to be allergic to the fibers in a certain type of dialyzer.

[Genlando]

Have they changed the dialyzers in the clinic

I don't think so.  Even so, I haven't had any allergic reactions since then. 

One thing that I'm now doing: I've started back taking Allegra everyday.  I normally only take it during the spring; however, I think I need to keep an antihistamine in my system at all times--especially since so many people have told me how many opportunities that I have for getting an allergic reaction in a dialysis center.   

[*kana*]

Sorry you are having so much trouble with hives.
 I giggled about the watermelon joke.....too funny! 
I can't believe that the ER told you that you weren't in any danger.  You can go from being ok to anaphalactic shock in a matter of minutes.  How do they know that your throat wouldn't start to close up soon after you left. 

The problem with allergies is you don't have to have anything new in or on your body to have a reaction.  It could be the soap you have been using for 20 years that all of a sudden you are allergic to.  Are bodies are always changing so look at everything as the culprit until you get it figured out.  Best of luck!   

[greg10]

Have they changed the dialyzers in the clinic

I don't think so.  Even so, I haven't had any allergic reactions since then. 

One thing that I'm now doing: I've started back taking Allegra everyday.  I normally only take it during the spring; however, I think I need to keep an antihistamine in my system at all times--especially since so many people have told me how many opportunities that I have for getting an allergic reaction in a dialysis center.

I have a theory on this.  Stay with me on this one.  Genlando mentioned in another thread that he has had power outages in his neighborhood caused by squirrels being electrocuted and vaporized on the power lines.  Now, think back carefully, when was the last time you were exposed to this "rodential haze"?  and when did you start having the hives? 

Alright, you know I won't be joking if you are still having hives.  It is a serious condition if it persists.

[thegrammalady]

you can get hives from eating something, ie strawberries, from the wrong laundry detergent or from no explainable reason. stress can be another cause. my 10 year old grandson gets them and we've never been able to figure out why. the er doctor told us she has had them. she is very close to her sister and broke out in hives the day her sister left for college and they came and went for 3 years until her sister returned home. my daughter broke out the first time she ate plums but hasn't had any problems since. so who knows.

[Genlando]

I have a theory on this.  Stay with me on this one.  Genlando mentioned in another thread that he has had power outages in his neighborhood caused by squirrels being electrocuted and vaporized on the power lines.  Now, think back carefully, when was the last time you were exposed to this "rodential haze"?  and when did you start having the hives?

Hmmm, interesting theory, Greg10.  I'm allergic to a bunch of different varieties of trees and grass.  It's possible that the squirrel had a belly full of acorns at the time of his demise, which could've triggered the allergic reaction.  There wasn't enough left over from Thursday evening's "Exploding Squirrel Extravaganza" to run a chemical analysis.  I tried to Google "how much acorn-residue is in a cubic centimeter of rodential haze?" but got no results.  I wonder why? 

Maybe we can get the U.S. government to fund a study to find out if people are allergic to acorn residue in exploding squirrels.  I'll call my Congressman tomorrow.

Oh, and still no relapse of the hives so far.

[Bruno]

But TGL is right Genlando, you can be allergic to anything. My downfall was Aspirin, of all things. My problem on dialysis was violent night sweats (and I mean real bad) but we traced it back to the filter, changed to a different type, and no more sweats (Thank you, God).
I've never heard of 'Pork' or 'Beef' heparin...what do they mean? I learn something everyday.
You may be interested to know that over here (Oz) we have a political party called the 'watermelons'...because they are Green on the outside but Red inside. Just thought I'd chuck that in.

[greg10]

..
I've never heard of 'Pork' or 'Beef' heparin...what do they mean? I learn something everyday...

Heparin is kind of a strange compound produced in the mast cells of many animals.  It is not clear what it does normally, but it may have something to do with immune response.  It is normally purified from mucosal tissues of slaughtered meat animals such as pig intestines or cow lungs.  There has been a FDA recall of contaminated heparin imported from China in 2008 that caused the death of 81 people in the US.
http://en.wikipedia.org/wiki/Heparin

[Genlando]

Thus quoth Bruno: But TGL is right Genlando, you can be allergic to anything. My downfall was Aspirin, of all things. My problem on dialysis was violent night sweats (and I mean real bad) but we traced it back to the filter, changed to a different type, and no more sweats (Thank you, God).
I've never heard of 'Pork' or 'Beef' heparin...what do they mean? I learn something everyday.

I've looked for what might have caused the hives outbreak, and can't think of anything.  The center says that they haven't made any recent changes to the SKU's for their filters, bloodlines or any of their cleaners.  I've been using unscented soaps for years now, and they haven't changed (I know this for a fact, because I buy the soap base from a wholesaler, and I make my own). 

It's now been 2 weeks with no relapse.   

You may be interested to know that over here (Oz) we have a political party called the 'watermelons'...because they are Green on the outside but Red inside. Just thought I'd chuck that in.

That wouldn't be a good name for a political party here, because watermelons are toxic to me!

I don't break out in hives if I eat watermelon. The roof of my mouth itches as soon as I take a bite of watermelon.  Then my throat gets scratchy, and I feel like I'm about to throw up, which I will do if I eat enough.  Then, I end up with severe diarrhea--burning diarrhea.  An allergist said that basically, my GI tract is having an allergic reaction to something in the fruit.

It's not just watermelon either.  I get the same reaction if I try to eat cantaloupe, honey dew, bananas, strawberries and kiwi fruit. I can eat peeled peaches, but I'll react to the skin of an unpeeled one.  Red apples are off limits, but I can eat most of the green, yellow or golden varieties.  I can tolerate most fruits if they're cooked. So, heat neutralizes whatever I'm reacting to.

Some people have said that I'm a unique puppy because of these allergies, but my daughter and grandson have the same issues, so that just makes me strange.