Case progress
Background
- 35, White Male, 185cm (6ft),75Kg(165lbs), smoker, drinking (wine with meals), no drugs
- No known allergy (food or other allergens)
- No known condition.
- Contact with cat and dog 1 week before (1 day)
- I visited an arboretum one day before.
- In march I had a difficulty breathing
- it went away with plant based medicines (Baraka,Astha15)
- clean x-ray, doctor diagnosis: Allergic rhinitis.
- before this episode I smoked IQOS heated cigarettes, after I stopped and went back regular cigarettes.
- Before the events described below
- I smoked heated cigarettes (other than IQOS) for about 2 weeks before this started, but was already stopped 4-5 days before.
- maybe 2 weeks before I noticed slightly swollen hands in the morning sometimes. It would go away during the day.
- a medical student noticed a slight limping. sometimes a leg felt “slow”, it would go away after moving for a while.
- I took an aspirin one day before Day 1.
Full description of how my medical issue went is below, starting from Day 1
Day 1 - 2020.10.19
- Rash on back of head and starting a little bit in other places
- I feel the itchiness started maybe 3-4 days before, but it was very light, not an inconvenience at all
- I went to the pharmacy and the the pharmacist suggested: Xyzal (basically Levocetirizine) and some corticoid creams
Treatment at this time:
- Xyzal - Levocetirizine 1/pill/day (5mg)
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Day 2 - 2020.10.20
- Rash is expanding. It seems it was worse in place where there was contact with something else, like the glasses, or back of the head (chair head-rest)
- I had an online appointment with a dermatologist, she suggested an extra antihistaminic, called Tamalis (Rupatadine) and some creams.
- Diagnosis: Allergic reaction
- Immediately after the consult, I had a small fever : 38°C/100°F
Treatment at this time:
- Xyzal - Levocetirizine 1/pill/day (5mg)
- Tamalis - Rupatadine 1/pill/day
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2020_10_20 (1)
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Day 3 - 2020.10.21
- Covid-19 test done (two days later the result will arrive negative)
- Slightly higher fever : 38.5°C/101.3°F
- Face is better
- Hands are swollen
- Rash extended from neck down
Treatment at this time:
- Xyzal - Levocetirizine 1/pill/day (5mg)
- Tamalis - Rupatadine 1/pill/day
- 1 adult paracetamol for the fever
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Day 4 - 2020.10.22
- I have seen a different dermatologist, in office (first doctor was online, and far from my town)
- Diagnosis: Acute allergic urticaria
- Pill Treatment is kept (but some other, different cream is prescribed)
- Recommendation is to eat only foods with low allergic impact and no condiments.
- fever starts in the evening : 38.5°C/101.3°F
- top body skin gets better, except for feet
Treatment at this time:
- Xyzal - Levocetirizine 1/pill/day (5mg)
- Tamalis - Rupatadine 1/pill/day
- Hydrocortisone hemisuccinate iv, 100mg
- 1 adult paracetamol for the fever
Day 5 - 2020.10.23
- no more fever
- everything is clear except the feet, still swollen
- hands are not swollen anymore, but kind of sore
Treatment at this time:
- Xyzal - Levocetirizine 1/pill/day (5mg)
- Tamalis - Rupatadine 1/pill/day
Doctor orders tests, results as follows:
* Proteina C reactiva...
14,870 mg/dL (<= 0,500)
148,70 mg/L (<= 5,00)
* IgE total...
598,3 UI/mL (< 158,0)
* Fibrinogen...7,72 g/L (1,7 - 4,2)
Neck and throat cultures:
ABSENT STREPTOCOCI BETA HEMOLITICI
ABSENT STAPHYLOCOCCUS AUREUS
ABSENT STREPTOCOCI BETA HEMOLITICI
Hemoleucograma...
Hematii....... 5130000 /mm3 (4570000 - 5980000)
Hemoglobina... 14,8 g/dL (13,9 - 17,7)
Hematocrit.... 45,5 % (39,6 - 51,8)
MCV........... 88,5 fL (80,1 - 95,3)
MCH........... 28,9 pg (27,6 - 33,2)
* MCHC.........32,6 g/dL (33,0 - 37,2)
RDW........... 12,7 % (11,5 - 14,7)
Trombocite.... 308000 /mm3 (150000 - 370000)
* Leucocite....10410 /mm3 (3790 - 10330)
FORMULA LEUCOCITARA:
Neutrofile... 49,00 % 5100 /mm3 (42,00 - 77,00)
* Limfocite...44,30 % 4620 /mm3 (20,00 - 44,00)
Monocite..... 4,80 % 500 /mm3 (2,00 - 9,50)
Eozinofile... 1,30 % 140 /mm3 (0,50 - 5,50)
Bazofile..... 0,60 % 60 /mm3 (0,00 - 1,75)
* VSH...........39 mm/h (<= 15)
TGO (ASAT)...18 U/L (15 - 40)
TGP (ALAT)...17 U/L (10 - 40)
Creatinina serica...
0,77 mg/dL (0,60 - 1,10)
68 μmol/L (53 - 97)
Creatinina urinara spot...
152 mg/dL (24 - 392)
13,4 mmol/L (2,1 - 34,7)
Feritina...
236,1 ng/mL (22,0 - 322,0)
519,4 pmol/L (48,4 - 708,4)
GGT (gama glutamiltransferaza)...30 U/L (< 73)
Glucoza...
96 mg/dL (74 - 106)
5,33 mmol/L (4,11 - 5,88)
Uree serica...
25,5 mg/dL (12,8 - 42,8)
4,3 mmol/L (2,1 - 7,1)
Urine test (biochimie + sediment)...
PH.................. 6,5 (5,0 - 8,0)
Densitate........... 1,018 (1,016 - 1,022)
Proteine............ negativ negativ
Glucoza............. normal normal
Corpi cetonici...... negativ negativ
Nitriti............. negativ negativ
Urobilinogen........ normal normal
Pigmenti biliari.... negativ negativ
Culoare............. Yellow (translated)
Aspect.............. Clear (translated)
SEDIMENT:
Eritrocite...........1 /μL (<17)
Leucocite............2 /μL (<28)
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Day 6 - 2020.10.24
- everything is clear except the feet, swelling is getting better
- hands fine
Treatment at this time:
- Xyzal - Levocetirizine 1/pill/day (5mg)
- Tamalis - Rupatadine 1/pill/day
More tests done as suggested by a different doctor (specialized in infectious disease):
* Proteina C reactiva...
6,680 mg/dL (<= 0,500) (prev value 14,870)
66,80 mg/L (<= 5,00) 148,70
* IgE total... 647,9 UI/mL (< 158,0) (prev value 598,3)
Examen coproparazitologic...
Negative for Giardia lambli, larvea, parasites
Ac. anti Echinococcus granulosus & multilocularis IgG..
0,110 Index (< 0,900)
Ac. anti Trichinella spiralis IgG...
0,676 Index (< 0,850)
Ac. anti Taenia solium IgG...
0,280 Index (< 0,900)
* Ac. anti Cytomegalovirus - IgG - calitativ...
8,32 Index (< 0,90)
Ac. anti Cytomegalovirus - IgM...
0,130 Index (< 0,900)
* Ac. anti virus Epstein Barr EBNA IgG...
74,3 U/mL (750,0 U/mL)
* Ac. anti virus Epstein Barr VCA IgG....
750,0 U/mL (< 20,0)
Ac. anti virus Epstein Barr VCA IgM......
10,0 U/mL (< 20,0)
Day 7 - 2020.10.25
- everything is clear, no more rash on the body
- Tamalis treatment ends, last pill today
- I’m feeling itching on hands and back of head, especially in the evening
- There are small wounds at the corners of the mouth
Treatment at this time:
- Xyzal - Levocetirizine 1/pill/day (5mg)
- Tamalis - Rupatadine 1/pill/day - last pill today
- Aciclovir cream for the corners of the mouth
Day 8 - 2020.10.26
- Xyzal treatment ends, last pill today
- I’m feeling itching on hands and back of head, especially in the evening
Treatment at this time:
- Xyzal - Levocetirizine 1/pill/day (5mg) - last pill
- Aciclovir cream for the corners of the mouth
Day 9 - 2020.10.27
- Everything feels fine, maybe slight itching
Treatment at this time:
- Aciclovir cream for the corners of the mouth
Day 10 - 2020.10.28
- I’m feeling itching on back of head, especially in the evening
- In late evening I observe small rashes appearing on the feet, hands and some small spots on the body
- The feet bottom of the feet feel sore, makes it incomfortable to walk (this has also happened the first time)
Treatment at this time:
- None
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Day 11 - 2020.10.29
- I’m feeling itching on almost the entire head (mostly back and top), all day
- I contact the doctor, Tamalis and Xyzal treatment is back for 5 more days.
Treatment at this time:
- Xyzal 1/pill/day (5mg)
- Tamalis - Rupatadine 1/pill/day
Day 12 - 2020.10.30
- There was prurit (itching) on hands and feet during the night
- The rash has expanded again, but it feels lees “aggressive” than the first time
- Wounds at the corner of the mouth are almost gone
- Pictures are taken ~36h from last time
Treatment at this time:
- Xyzal 1/pill/day (5mg)
- Tamalis - Rupatadine 1/pill/day
- Aciclovir cream for the corners of the mouth
Day 13 - 2020.10.31
- I have seen an allergy-immunology doctor, so my treatment will change.
- In the morning, rash has gotten worse than yesterday, it’s already all over the body and face.
- Wounds at the corner of the mouth are gone
- Today, I started the treatment in the afternoon
- The was a small fever during the day, just like last time when the rash was covering the entire body.
- In the evening, it looks like the rash is subsiding (still present everywhere).
Treatment at this time:
- Medrol - Prednisone (3*16mg) 2 - 1 - 0 - 10 days
- Xyzal - Levocetirizine (2* 5mg) 1 - 0 - 1 - 30 days
- Borenar - Bilastine (2*20mg) 1 - 0 - 1 - 30 days
- Nexium - Esomeprazole (2*20mg) 1 - 1 - 0 - 10 days
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Day 14 - 2020.11.01
- In the afternoon, the rash is mostly gone, only small red dots remain (3 Medrol pills taken so far)
- In the evening, there was itching on the head and feet (most red dots are on the feet and hands, I can’t check the head due to hair). Maybe light itching on arms, back of ears
Treatment at this time:
- Medrol - Prednisone (3*16mg) 2 - 1 - 0 - 10 days
- Xyzal - Levocetirizine (2* 5mg) 1 - 0 - 1 - 30 days
- Borenar - Bilastine (2*20mg) 1 - 0 - 1 - 30 days
- Nexium - Esomeprazole (2*20mg) 1 - 1 - 0 - 10 days
Day 15 - 2020.11.02
- In the morning, rash has expanded on the feet and hands, but the pills are definitely doing something, as it’s smaller than before.
- Pictures taken in the morning
- The doctor suggests I increase medrol to 4/day
- In the evening situation has improved - rash circles look like dots now
Treatment at this time:
- Medrol - Prednisone (4*16mg) 2 - 2 - 0
- Xyzal - Levocetirizine (2* 5mg) 1 - 0 - 1
- Borenar - Bilastine (2*20mg) 1 - 0 - 1
- Nexium - Esomeprazole (2*20mg) 1 - 1 - 0
Day 16 - 2020.11.03
- Rash almost subsided, small red dots remain, scattered, rare, all over the body.
- Itchiness is almost gone, but still flares up to manageable level throughout the day
Treatment at this time:
- Medrol - Prednisone (4*16mg) 2 - 2 - 0
- Xyzal - Levocetirizine (2* 5mg) 1 - 0 - 1
- Borenar - Bilastine (2*20mg) 1 - 0 - 1
- Nexium - Esomeprazole (2*20mg) 1 - 1 - 0
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Day 17- 2020.11.04
- Rash almost subsided, small red dots remain, scattered, rare, all over the body.
- Itchiness is almost gone, but still flares up to manageable level throughout the day (less than before)
- I did a little effort today, red spots appeared on the feet, but less than day 17
Treatment at this time:
- Medrol - Prednisone (4*16mg) 2 - 2 - 0
- Xyzal - Levocetirizine (2* 5mg) 1 - 0 - 1
- Borenar - Bilastine (2*20mg) 1 - 0 - 1
- Nexium - Esomeprazole (2*20mg) 1 - 1 - 0
Day 18- 2020.11.05
- Small red dots remain, scattered, rare, all over the body. Some appear and then go away next day.
- More tests done, per the doctor recommendation:
ALEX-MADx, serologic test for 282 allergens. All negative.
*Fibrinogen...
- 4,38 g/L (1,7 - 4,2) prev: 28/10/2020 5,03
* IgE total...
- 760,1 UI/mL (< 158,0) 24/10/2020 647,9
* Proteina C reactiva...
- 0,667 mg/dL (<= 0,500) 28/10/2020 1,012
- 6,67 mg/L (<= 5,00) 10,12
TSH (hormon hipofizar tireostimulator bazal)...
- 0,6300 μUI/mL (0,5500 - 4,7800)
* VSH... 22 mm/h (<= 15) 28/10/2020 18
Ac. anti Herpes simplex virus 1/2 IgM
- < 0,50 Index (< 0,90)
Hemoleucograma...
Hematii....... 5290000 /mm3 (4570000 - 5980000) 28/10/2020 5450000
Hemoglobina... 15,2 g/dL (13,9 - 17,7) 28/10/2020 15,7
Hematocrit.... 45,9 % (39,6 - 51,8) 28/10/2020 47,9
MCV........... 86,7 fL (80,1 - 95,3) 28/10/2020 88,0
MCH........... 28,8 pg (27,6 - 33,2) 28/10/2020 28,8
MCHC.......... 33,2 g/dL (33,0 - 37,2) 28/10/2020 32,7
RDW........... 12,5 % (11,5 - 14,7) 28/10/2020 12,6
*Trombocite.... 440000 /mm3 (150000 - 370000) 28/10/2020 382000
*Leucocite..... 13760 /mm3 (3790 - 10330) 28/10/2020 10360
FORMULA LEUCOCITARA:
Neutrofile... 73,40 % 10100 /mm3 (42,00 - 77,00) 28/10/2020 60,80
*Limfocite.... 18,70 % 2570 /mm3 (20,00 - 44,00) 28/10/2020 32,50
Monocite..... 7,60 % 1050 /mm3 (2,00 - 9,50) 28/10/2020 4,90
*Eozinofile... 0,20 % 20 /mm3 (0,50 - 5,50) 28/10/2020 1,20
Bazofile..... 0,10 % 20 /mm3 (0,00 - 1,75) 28/10/2020 0,60
Ac. anti Helicobacter pylori - IgG - cantitativ
- 3,37 U/mL normal: (< 0,90)
Ac. anti Toxocara canis IgG...
- 0,134 Index (< 0,900)
Treatment at this time:
- Medrol - Prednisone (4*16mg) 2 - 2 - 0
- Xyzal - Levocetirizine (2* 5mg) 1 - 0 - 1
- Borenar - Bilastine (2*20mg) 1 - 0 - 1
- Nexium - Esomeprazole (2*20mg) 1 - 1 - 0
Day 19- 2020.11.06
- Small red dots seem to be gone, also the itching is going away (almost none remaining)
Treatment at this time:
- Medrol - Prednisone (4*16mg) 2 - 2 - 0
- Xyzal - Levocetirizine (2* 5mg) 1 - 0 - 1
- Borenar - Bilastine (2*20mg) 1 - 0 - 1
- Nexium - Esomeprazole (2*20mg) 1 - 1 - 0
Day 20- 2020.11.07
- Small red dots seem to be gone, also the itching is going away (almost none remaining)
Treatment at this time:
- Medrol - Prednisone (4*16mg) 2 - 2 - 0
- Xyzal - Levocetirizine (2* 5mg) 1 - 0 - 1
- Borenar - Bilastine (2*20mg) 1 - 0 - 1
- Nexium - Esomeprazole (2*20mg) 1 - 1 - 0
Day 21- 2020.11.08
- Small red dots seem to be gone, also the itching is going away (almost none remaining)
- I spent around ~4h in a forested area, minimal effort.
- Towards the end of the day, the dots appeared on the hands, around the neck. If as before, they will go away by morning.
Treatment at this time:
- Medrol - Prednisone (4*16mg) 2 - 2 - 0
- Xyzal - Levocetirizine (2* 5mg) 1 - 0 - 1
- Borenar - Bilastine (2*20mg) 1 - 0 - 1
- Nexium - Esomeprazole (2*20mg) 1 - 1 - 0
Day 22- 2020.11.09
- Treatment is reduced now.
- Small red dots appear, near the neck area, but dissapear in few our after I take the antihistamines or the prednisone
Treatment at this time:
- Medrol - Prednisone (2*16mg) 1 - 1 - 0
- Xyzal - Levocetirizine (2* 5mg) 0 - 0 - 1
- Borenar - Bilastine (2*20mg) 1 - 0 - 0
- Nexium - Esomeprazole (2*20mg) 1 - 1 - 0
Day 23- 2020.11.10
- Small red dots appear, near the neck area, but dissapear in few our after I take the antihistamines or the prednisone
Treatment at this time:
- Medrol - Prednisone (3*16mg) 1 - 1 - 0
- Xyzal - Levocetirizine (2* 5mg) 0 - 0 - 1
- Borenar - Bilastine (2*20mg) 1 - 0 - 0
- Nexium - Esomeprazole (2*20mg) 1 - 1 - 0
Day 24- 2020.11.11
- Less small red dots are visible.
Treatment at this time:
- Medrol - Prednisone (2*16mg) 1 - 1 - 0
- Xyzal - Levocetirizine (2* 5mg) 0 - 0 - 1
- Borenar - Bilastine (2*20mg) 1 - 0 - 0
- Nexium - Esomeprazole (2*20mg) 1 - 1 - 0
Day 25- 2020.11.12
- Eruption on chest in the morning, grew slightly during the day.
- I have seen the doctor again. In addition to the management medication for the urticaria, I get a course for antibiotics for suspected Helicobacter Pylori.
- Xyzal and Borenar I should take “as needed” 2/day if eruption present, 1/day otherwise
Treatment at this time:
- Medrol - Prednisone (2* 16mg) 1 - 1 - 0
- Xyzal - Levocetirizine (2* 5mg) 1 - 0 - 1
- Borenar - Bilastine (2* 20mg) 1 - 0 - 1
- Nexium - Esomeprazole (2* 20mg) 1 - 1 - 0
- KLACID - Clarithromycin (2* 500mg) 1 - 0 - 1
- Amoxicilin (2*1000mg) 1 - 0 - 1
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Day 26- 2020.11.13
- Eruption on chest is less than the day before (picture taken in the morning)
- In the afternoon it’s almost gone.
Treatment at this time:
- Medrol - Prednisone (2* 16mg) 1 - 1 - 0
- Xyzal - Levocetirizine (2* 5mg) 1 - 0 - 1
- Borenar - Bilastine (2* 20mg) 1 - 0 - 1
- Nexium - Esomeprazole (2* 20mg) 1 - 1 - 0
- KLACID - Clarithromycin (2* 500mg) 1 - 0 - 1
- Amoxicilin (2*1000mg) 1 - 0 - 1
Day 27- 2020.11.14
- Eruption is gone, but in general, it feels the skin is redish, especially in the area below the neck and palms.
Treatment at this time:
- Medrol - Prednisone (2* 16mg) 1 - 1 - 0
- Xyzal - Levocetirizine (2* 5mg) 1 - 0 - 1
- Borenar - Bilastine (2* 20mg) 1 - 0 - 1
- Nexium - Esomeprazole (2* 20mg) 1 - 1 - 0
- KLACID - Clarithromycin (2* 500mg) 1 - 0 - 1
- Amoxicilin (2*1000mg) 1 - 0 - 1
Day 28- 2020.11.15
- In the morning, the skin is still red in the area below the neck and palms.
- In the afternoon, before the second round of pills, in the neck area, thre were small red dots, similar to day 27. They subside 2-3h after I take the medrol and antihistamines.
- Stool becomes regular and consistent.
Treatment at this time:
- Medrol - Prednisone (2* 16mg) 1 - 1 - 0
- Xyzal - Levocetirizine (2* 5mg) 1 - 0 - 1
- Borenar - Bilastine (2* 20mg) 1 - 0 - 1
- Nexium - Esomeprazole (2* 20mg) 1 - 1 - 0
- KLACID - Clarithromycin (2* 500mg) 1 - 0 - 1
- Amoxicilin (2*1000mg) 1 - 0 - 1
Day 29- 2020.11.16
- It was better overall, there were no dots when I woke up and it was ok during the day.
- Reddish skin on palms and neck area persists.
Treatment at this time:
- Medrol - Prednisone (2* 16mg) 1 - 1 - 0
- Xyzal - Levocetirizine (2* 5mg) 1 - 0 - 1
- Borenar - Bilastine (2* 20mg) 1 - 0 - 1
- Nexium - Esomeprazole (2* 20mg) 1 - 1 - 0
- KLACID - Clarithromycin (2* 500mg) 1 - 0 - 1
- Amoxicilin (2*1000mg) 1 - 0 - 1
Day 30- 2020.11.17
- In the morning, I woke up with a rash on the neck area and forhead. As before, 2-3h after I took the antihistamines and medrol, this is subsiding.
- In the evening, the rash is gone.
- Reddish skin on palms and neck area persists.
Treatment at this time:
- Medrol - Prednisone (2* 16mg) 1 - 1 - 0
- Xyzal - Levocetirizine (2* 5mg) 1 - 0 - 1
- Borenar - Bilastine (2* 20mg) 1 - 0 - 1
- Nexium - Esomeprazole (2* 20mg) 1 - 1 - 0
- KLACID - Clarithromycin (2* 500mg) 1 - 0 - 1
- Amoxicilin (2*1000mg) 1 - 0 - 1
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Day 31- 2020.11.18
- No rash today.
- Reddish skin on palms and neck area persists.
- More tests done to check for antibiotic treatment response:
Factor reumatoid... Rheumatoid factor
< 3,5 UI/mL (< 14,0)
Fibrinogen...
2,67 g/L (1,7 - 4,2) 05/11/2020 4,38
*IgE total...
1313,6 UI/mL (< 158,0) 05/11/2020 760,1
Proteina C reactiva...
< 0,050 mg/dL (<= 0,500) 05/11/2020 0,667
VSH...
6 mm/h (<= 15) 05/11/2020 22
Aspergillus Antibodies 1: < 80 reference: 1: < 80
Hemoleucograma...
Hematii....... 5770000 /mm3 (4570000 - 5980000) 05/11/2020 5290000
Hemoglobina... 16,2 g/dL (13,9 - 17,7) 05/11/2020 15,2
Hematocrit.... 50,8 % (39,6 - 51,8) 05/11/2020 45,9
MCV........... 88,0 fL (80,1 - 95,3) 05/11/2020 86,7
MCH........... 28,1 pg (27,6 - 33,2) 05/11/2020 28,8
*MCHC.......... 32,0 g/dL (33,0 - 37,2) 05/11/2020 33,2
RDW........... 13,8 % (11,5 - 14,7) 05/11/2020 12,5
Trombocite.... 326000 /mm3 (150000 - 370000) 05/11/2020 440000
*Leucocite..... 14840 /mm3 (3790 - 10330) 05/11/2020 13760
FORMULA LEUCOCITARA:
*Neutrofile... 85,70 % 12720 /mm3 (42,00 - 77,00) 05/11/2020 73,40
*Limfocite.... 10,30 % 1530 /mm3 (20,00 - 44,00) 05/11/2020 18,70
Monocite..... 3,80 % 560 /mm3 (2,00 - 9,50) 05/11/2020 7,60
*Eozinofile... 0,10 % 10 /mm3 (0,50 - 5,50) 05/11/2020 0,20
Bazofile..... 0,20 % 20 /mm3 (0,00 - 1,75) 05/11/2020 0,10
Treatment at this time:
- Medrol - Prednisone (2* 16mg) 1 - 1 - 0
- Xyzal - Levocetirizine (2* 5mg) 1 - 0 - 1
- Borenar - Bilastine (2* 20mg) 1 - 0 - 1
- Nexium - Esomeprazole (2* 20mg) 1 - 1 - 0
- KLACID - Clarithromycin (2* 500mg) 1 - 0 - 1
- Amoxicilin (2*1000mg) 1 - 0 - 1
Day 32- 2020.11.19
- No rash today. Overall feeling much better.
Treatment at this time:
- Medrol - Prednisone (2* 16mg) 1 - 1 - 0
- Xyzal - Levocetirizine (2* 5mg) 1 - 0 - 1
- Borenar - Bilastine (2* 20mg) 1 - 0 - 1
- Nexium - Esomeprazole (2* 20mg) 1 - 1 - 0
- KLACID - Clarithromycin (2* 500mg) 1 - 0 - 1
- Amoxicilin (2*1000mg) 1 - 0 - 1
Day 33- 2020.11.20
- No rash today. Overall feeling much better.
Treatment at this time:
- Medrol - Prednisone (2* 16mg) 1 - 1 - 0
- Xyzal - Levocetirizine (2* 5mg) 1 - 0 - 1
- Borenar - Bilastine (2* 20mg) 1 - 0 - 1
- Nexium - Esomeprazole (2* 20mg) 1 - 1 - 0
- KLACID - Clarithromycin (2* 500mg) 1 - 0 - 1
- Amoxicilin (2*1000mg) 1 - 0 - 1
Day 34- 2020.11.21
- No rash today. Overall feeling much better.
- The skin on the hands is very dry, so I’m applying some mosturizer.
Treatment at this time:
- Medrol - Prednisone (2* 16mg) 1 - 1 - 0
- Xyzal - Levocetirizine (2* 5mg) 1 - 0 - 1
- Borenar - Bilastine (2* 20mg) 1 - 0 - 1
- Nexium - Esomeprazole (2* 20mg) 1 - 1 - 0
- KLACID - Clarithromycin (2* 500mg) 1 - 0 - 1
- Amoxicilin (2*1000mg) 1 - 0 - 1
Day 35- 2020.11.22
- No rash.
- Palms are reddish and the area around the neck is reddish. This was true for all days when there was no rash.
- Antibiotic treatment ends today, after the morning dose. - 10 day course.
- Today I did more effort than usual.
Treatment at this time:
- Medrol - Prednisone (2* 16mg) 1 - 1 - 0
- Xyzal - Levocetirizine (2* 5mg) 1 - 0 - 1
- Borenar - Bilastine (2* 20mg) 1 - 0 - 1
- Nexium - Esomeprazole (2* 20mg) 1 - 1 - 0
- KLACID - Clarithromycin (2* 500mg) 1 - 0 - 0
- Amoxicilin (2*1000mg) 1 - 0 - 0
Day 36- 2020.11.23
- Same as yesterday
Treatment at this time:
- Medrol - Prednisone (2* 16mg) 1 - 1 - 0
- Xyzal - Levocetirizine (2* 5mg) 1 - 0 - 1
- Borenar - Bilastine (2* 20mg) 1 - 0 - 1
- Nexium - Esomeprazole (2* 20mg) 1 - 1 - 0
Day 37- 2020.11.24
- something is wrong in the left foot
- it is painfull to step on it.
- no visible/or maybe minor swelling
- it hurts slightly if I press on the side of foot with my finger(picture).
- in the evening, before taking the pills, there were red dots on the hands, above te palms. like before, they go away 2-3h after I take the medicine
- in the evening, I feel slight itchiness on the head
Treatment at this time:
- Medrol - Prednisone (2* 16mg) 1 - 1 - 0
- Xyzal - Levocetirizine (2* 5mg) 1 - 0 - 1
- Borenar - Bilastine (2* 20mg) 1 - 0 - 1
- Nexium - Esomeprazole (2* 20mg) 1 - 1 - 0
.JPG)
.JPG)
Day 38- 2020.11.25
- left foot is getting better but I can still feel it when I step
- no rash, but some itching on the head and ears (where the glasses rest)
Day 39- 2020.11.26
- no rash, less itching
- left foot is better
Treatment at this time:
- Medrol - Prednisone (2* 16mg) 1 - 1 - 0
- Xyzal - Levocetirizine (2* 5mg) 1 - 0 - 1
- Borenar - Bilastine (2* 20mg) 1 - 0 - 1
- Nexium - Esomeprazole (2* 20mg) 1 - 1 - 0
Day 40- 2020.11.27
- no rash, even less itching
- I’m reducing the prednisone from 16mg/day to 8mg/day
- left foot pain almost gone
Treatment at this time:
- Medrol - Prednisone (2* 8mg) 1 - 1 - 0
- Xyzal - Levocetirizine (2* 5mg) 1 - 0 - 1
- Borenar - Bilastine (2* 20mg) 1 - 0 - 1
- Nexium - Esomeprazole (2* 20mg) 1 - 1 - 0
Day 41- 2020.12.02
- no rash, minor itching here and then
- I stop medrol and nexium treatment
Treatment at this time:
- Xyzal - Levocetirizine (2* 5mg) 1 - 0 - 1
- Borenar - Bilastine (2* 20mg) 1 - 0 - 1
Day 53- 2020.12.09
- no rash, very minor itching troughout the day
- I have noticed my face is swollen by comparison to when I was taking medrol. In retrospect I was probably slightly swollen before the urticaria started, but just thought I was getting fat.
- the lymph node under my left armpit is slightly swollen. it is soft to the touch and not painfull
- I have taken some ibuprofen from time to time, as recommended by the family doctor (to replace medrol).
- the area underneath the neck is slightly red in the evening and morning, but significantly less red after I take Xyzal/Borenar
Treatment at this time:
- Xyzal - Levocetirizine (2* 5mg) 1 - 0 - 1
- Borenar - Bilastine (2* 20mg) 1 - 0 - 1
Day 57- 2020.12.13
- red patches appear and dissapear troughout the day (hands, neck area)
- face swelling seems to have gotten less
- the lymph node under my left armpit is slightly swollen, maybe a bit less than 4 days ago.
- I am now taking ibuprofen twice a day
Treatment at this time:
- Xyzal - Levocetirizine (2* 5mg) 1 - 0 - 1
- Borenar - Bilastine (2* 20mg) 1 - 0 - 1
- Ibuprofen (2* 400mg) 1 - 0 - 1
Day 63- 2020.12.19
- red patches appear and dissapear troughout the day (hands, neck area)
- face swelling is the same as before, maybe a bit less when I take ibuprofen
- the lymph node under my left armpit is slightly swollen,same as before
- there is productive coughing, especially in the morning and a few times during the day
- I’m reducing Xyzal/Borenar for 2/day each to 1/day each
Treatment at this time:
- Xyzal - Levocetirizine (2* 5mg) 0 - 0 - 1
- Borenar - Bilastine (2* 20mg) 1 - 0 - 0
- Ibuprofen (2* 400mg) 1 - 0 - 1
Day 66- 2020.12.22
- red patches appear and dissapear troughout the day (hands, neck area)
- the lymph node under my left armpit is slightly swollen,same as before
- there is productive coughing, especially in the morning and a few times during the day
As recommended by the doctor, I take the following tests:
Erythrocyte sedimentation rate
*VSH... 18 mm/h (<= 15) 18/11/2020 6
*Proteina C reactiva...0,716 mg/dL (<= 0,500) 18/11/2020 <0,050
*Fibrinogen... 4,83 g/L (1,7 - 4,2) 18/11/2020 2,67
Hemoleucograma...
Hematii....... 5480000 /mm3 (4570000 - 5980000) 18/11/2020 5770000
Hemoglobina... 15,3 g/dL (13,9 - 17,7) 18/11/2020 16,2
Hematocrit.... 48,0 % (39,6 - 51,8) 18/11/2020 50,8
MCV........... 87,6 fL (80,1 - 95,3) 18/11/2020 88,0
MCH........... 28,0 pg (27,6 - 33,2) 18/11/2020 28,1
*MCHC.......... 31,9 g/dL (33,0 - 37,2) 18/11/2020 32,0
RDW........... 14,4 % (11,5 - 14,7) 18/11/2020 13,8
Trombocite.... 299000 /mm3 (150000 - 370000) 18/11/2020 326000
*Leucocite..... 13260 /mm3 (3790 - 10330) 18/11/2020 14840
FORMULA LEUCOCITARA:
Neutrofile... 60,40 % 8010 /mm3 (42,00 - 77,00) 18/11/2020 85,70
Limfocite.... 33,40 % 4430 /mm3 (20,00 - 44,00) 18/11/2020 10,30
Monocite..... 5,10 % 680 /mm3 (2,00 - 9,50) 18/11/2020 3,80
Eozinofile... 0,50 % 70 /mm3 (0,50 - 5,50) 18/11/2020 0,10
Bazofile..... 0,50 % 70 /mm3 (0,00 - 1,75) 18/11/2020 0,20
Feritina...
212,7 ng/mL (22,0 - 322,0) 23/10/2020 236,1
467,9 pmol/L (48,4 - 708,4) 519,4
Timp Quick...
PROBA:
TQ................. 10,3 ''
IQ................. 131 %
INR................ 0,86
MARTOR:
TQ................. 11,9 ''
IQ................. 100 %
INR................ 1,00
D-Dimer... 0,36 mg/L (< 0,50)
Ac. anti SARS-CoV-2 IgG...1,10 AU/mL (< 10,00)
Interpretare:
IgG < 10 AU/mL ..... Negativ
IgG >= 10 AU/mL ..... Pozitiv
Ac. anti SARS-CoV-2 IgM...0,16 AU/mL (< 10,00)
Interpretare:
IgM < 10 AU/mL ..... Negativ
IgM >= 10 AU/mL ..... Pozitiv
Glucoza...
82 mg/dL (74 - 106) 23/10/2020 96
4,55 mmol/L (4,11 - 5,88) 5,33
Treatment at this time:
- Xyzal - Levocetirizine (2* 5mg) 0 - 0 - 1
- Borenar - Bilastine (2* 20mg) 1 - 0 - 0
- Ibuprofen (2* 400mg) 1 - 0 - 1
My questions
My understanding is that the sympthoms are treated, but the trigger is unknown, and it could be infectious, alergenic, auto-imune, caused by parasites or something else
- What else should I check ?
- I fear that, after the treatment is complete, this will return.