Allergic Reactions in Kids?

[Paige]

What does an allergic reaction in kids with dangerous allergies look like the first few times? Can you please give me a brief description?

 

My DS (10) went to the ER last night and they still have no idea what caused his reaction. They can't decide if it was an allergic response or viral. We were sent home with a prescription for an epipen as a precaution.

 

He had a normal day, ate normal food, and played outside in our yard as usual. After lunch he had a bit of an upset stomach and diarrhea. Around dinner time, he didn't want to eat and said he had a rash. He had a mild rash a few places on his neck and arms. About an hour later, the rash was bumpier and redder and was everywhere. He was very upset and said it itched. We gave him some benadryl and he took a bath in Epsom salts and went to bed. About 30 min later,he came to us and his skin was even worse, the rash had swollen more and was redder, with bumps closer together. He was crazed with itching and could not be calmed. DH took him to the ER and the rash and itching started to get better shortly after he arrived with no other treatment. They think the benadryl was finally working. Even though the rash was fading, they kept him for about 4hrs because his heart rate was very high. He had an EKG which was normal but he threw up the pills they gave him. DH said he slept most of the time he was there and he's still asleep now after 11am the next day. This is a kid who never sleeps in. He has no fever, no more rash, and no more complaints of upset stomach. I've checked on him and he says he's just tired.

 

Does that sound like an allergic response? I would think viral except that the rash came and went so quickly. The ER doctor said he was leaning towards viral but wanted us to get the epipen and keep it on us just in case. If he's allergic to something, I'd want to take him somewhere and try to find out what the trigger is. He had a similar rash one other time about 2yrs ago and we never found out what caused it but this time was much worse and came on much quicker.

[MrsBear]

With DS we had a bunch of warning signs before connecting the dots to realize it was an allergic reaction to fish.

 

The first we remember was on a fishing trip, he got hives around his face that swelled his eyes almost shut - DH thought he'd touched the fish cleaning station and came in contact with a bacteria known to cause skin problems and hives. It was that, or perhaps some environmental allergen since DH has allergies to trees, pollen and grasses. We didn't think it was the fish he touched while his photo was being taken with DH.

 

Other warning signs we didn't connect were a couple of episodes where he puked - we thought tummy bug since his episodes were not immediately after eating fish or us eating fish near him. He'd also sporadically get hives/rashes that itched, but there were always a bunch of other things it might be, usually environmental (like grass or pollen) that we didn't pinpoint it for a couple of years.

 

What prompted our trip to the allergist was his reaction in a restaurant....an almost immediate projectile vomiting upon eating a very small sample of my fish, swelling of his eyes and mouth and body hives all over. Apparently, in time, allergies get worse, so minor reactions in time become worse with each exposure. We had a full panel done with the allergist and it showed that he's highly allergic to fish, all fish, even airborne particles. He has an epipen since the allergist said his reaction is multi-systemic, so he could become anaphylatic and have his breathing impaired with another exposure.

 

Thankfully since we found out what it is that he is allergic to, we've been able to avoid exposure and he's not had another reaction since. We avoid eating in open air kitchen restaurants, avoid fish & asian restaurants, make sure that when we do eat in places where cross-contamination is possible that we're clear about the allergy, and no longer consume fish in our home. Family members know of the allergy and if we're visiting they're great about not serving fish too. We've also provided family with a list of ingredients that contain fish that one doesn't usually think "fish" when using, like Worcestershire sauce, and when eating at friends, I usually ask about ingredients in foods that often contain ingredients that might have fish in them for DS to avoid if they're used.

Edited April 16, 2012 by MrsBear

[wapiti]

By "rash" I assume you mean hives? Hives would definitely be an allergic reaction of the potentially very dangerous variety.

 

Even if they weren't hives, the ichiness you describe would seem to be an allergic reaction. It's hard to imagine that a viral rash (which would look like tiny red bumps rather than hives, which typically have a white center and are "puffy-er") would come with an increased heart rate in the absence of fever.

 

I'd see an allergist.

[Paige]

No, it wasn't really what I'd call hives. It was tiny raised bumps all over his body. My first thought was it looked like roseola but then it spread so fast and kept getting redder and I've never seen a viral rash look like that. I've had hives and those are usually really big and nasty, right? His were tiny but there were thousands of them. When he was a baby, he'd get something sort of like that from suntan lotion. All of the tiny bumps together would look like he had gotten sunburnt very quickly. It was only when you looked closer that you could tell the redness was from a rash. He doesn't react to suntan lotion anymore, however.

[wapiti]

No, it wasn't really what I'd call hives. It was tiny raised bumps all over his body. My first thought was it looked like roseola but then it spread so fast and kept getting redder and I've never seen a viral rash look like that. I've had hives and those are usually really big and nasty, right? His were tiny but there were thousands of them. When he was a baby, he'd get something sort of like that from suntan lotion. All of the tiny bumps together would look like he had gotten sunburnt very quickly. It was only when you looked closer that you could tell the redness was from a rash. He doesn't react to suntan lotion anymore, however.

 

I'd say allergy because of the itch. The sort of rash you describe happens to a couple of my kids (with very sensitive skin) when they come into contact with grass, particularly at certain times of the year.

 

What you might google is whether an increased heartrate is involved in anaphylaxis. I have no idea.

 

The only other possibility that comes to mind is strep, particularly if he's been sick recently, though I don't believe that itches. Also, when my kids have had viral rashes, they were not itchy.

[MrsBear]

 

What you might google is whether an increased heartrate is involved in anaphylaxis. I have no idea.

 

 

Anaphylaxis can include an increased heart rate, drop in blood pressure, weakness, plus a bunch of other symptoms like hives, breathing difficulty, etc.

[sbgrace]

First, your ER handled that extremely well. I'm impressed. Most don't do that well with allergic reactions. Keeping him longer for observation and giving you the epi pen were the exact right things to do.

 

Even hives are most often viral in nature and, to my knowledge, viral hives itch like regular hives. I'd assume a viral rash would do the same. Still no fever, no other symptoms, and spreading/worsening like that seems strange for viral. You've had allergic rashes before in him. He threw up...that could have been part of an allergic/anaphylactic reaction. It was part of my son's but it went with a blood pressure plummet and included losing bowel control, swelling, color rushing out of skin, etc. If your son's blood pressure dropped the ER would have known. My son is tired after anaphylaxis and a virus might do that as well so I don't see fatigue as indicative one way or the other.

 

I'm glad you have an epi pen. If your gut is thinking allergic I'd see an allergist but I agree with the ER doctor that it's hard to tell in this case. So I'm not sure what to recommend. The truth is an allergist could allergy test him but, because food allergy testing has a high false positive rate, fishing around for an allergy without any indicator of what it might have been can cause problems. If you get a positive you won't know if it's a true allergy let alone the cause of this. I guess they could do an in office challenge of whatever it is but they'd likely first do a blood test and even then usually with anaphylaxis they won't do that. It would be a lot of money and since he didn't eat anything "new" I don't lean in that direction. I think environmental allergy testing is more accurate/less false positive rate. If that's true maybe a panel of whatever allergens (grasses?) are in the environment there right now would be helpful. If it's positive you could warn him not to roll in grass, give zyrtec or benadryl before going out, etc.

Edited April 16, 2012 by sbgrace

[61Keys]

Hi,

 

I'm new here but well versed in allergies. All 3 of my kids have allergies as do I. I've been anaphylactic for 2/3 of my life and am a double epi carrier. Not a one of us express allergies in the same way. One child's hives look more like a pinpoint rash, another looks like the flat raise bumps that get your attention as hives, the other one rarely gets any outward signs. From your description of the rash/hives, it could go either way. The raise heartbeat makes me think anaphylaxis. From this point on, I would always have benedryl handy.

 

You say he did/ate "normal" things all day. Allergies come from "normal" things not unusual things. One day your body decides "enough"! I'd zero in on lunch because of the tummy problems right after.

 

Good luck!

[MomatHWTK]

This website offers several informational publications that can help you figure things out:

http://www.kidswithfoodallergies.org/resourcesnew.php

 

For us- the odds are that it would be an allergic reaction. But we already know DS is highly allergic. Illness can also cause a rash, so you are really in a wait and see position. Sorry.