Urticaria and Its Possible Link to Rheumatoid Arthritis

Morning stiffness, urticaria, rheumatoid arthritis?

Hello Doctor, last Monday night I accidentally ingested shrimp powder, which caused me to develop hives the next day.
At that time, I only went to the pharmacy to buy antihistamines, taking one in the morning and evening on Tuesday and Wednesday, and one before bed on Thursday and Friday.
After that, I stopped the medication, but my hives did not completely resolve.
Different parts of my body are itchy, and if I scratch, it becomes red, warm, swollen, and painful, but there are no large rashes, just redness.
On Saturday and Sunday, the itchy areas were on my palms, the backs of my hands, the soles of my feet, and the tops of my feet.
This morning, Monday, I woke up feeling that my fingers and toes are somewhat stiff and difficult to bend.
This has persisted throughout the day; bending them feels tight, and I experience some pain when holding a pen or opening a door.
Taking a hot shower did not provide much relief.
Recently, I have also had a poor appetite, and the week before last, I experienced unexplained eye pain, but when I visited an ophthalmologist, they said my eyes were fine.
I would like to ask if this condition could be rheumatoid arthritis? Can hives lead to rheumatoid arthritis? If so, would it be suitable for me to continue my studies, or should I take a break? (I am currently a junior in college) Thank you, Doctor.

Xiao Lin, 20~29 year old female. Ask Date: 2018/10/15

Dr. Gao Jiankai reply Internal Medicine

Hello, Xiaolin.
Thank you for your question.
I believe your initial concerns are related to urticaria.
Some cases of urticaria can have a prolonged duration, starting with widespread symptoms and gradually becoming localized to a few areas, at which point typical urticaria manifestations may be less apparent.
Therefore, the swelling of your fingers and toes may also be related to urticaria.
As for your eye symptoms, I cannot provide specific advice based on your description; however, your symptoms should not be related to rheumatoid arthritis, so there is no need for concern.
Of course, to determine the exact nature of your issue, it would be more accurate for a physician to evaluate your symptoms in person.
The Allergy, Immunology, and Rheumatology Department at Changhua Hospital, Ministry of Health and Welfare, is here to support you.

Reply Date: 2018/10/15

More Info

Urticaria, commonly known as hives, is a skin condition characterized by itchy, raised welts that can appear anywhere on the body. It can be triggered by various factors, including food allergies, medications, and environmental factors. In your case, it seems that the consumption of shrimp powder led to an allergic reaction, resulting in urticaria. While urticaria itself is not directly linked to rheumatoid arthritis (RA), there are some connections worth discussing.

Rheumatoid arthritis is an autoimmune disorder that primarily affects the joints, leading to inflammation, pain, and eventually joint damage. It is characterized by chronic inflammation, which can sometimes be accompanied by systemic symptoms such as fatigue, fever, and malaise. While urticaria is not a typical symptom of RA, autoimmune conditions can sometimes present with overlapping symptoms, including skin manifestations.

Your experience of persistent itching and localized redness without the formation of large welts is not uncommon in cases of chronic urticaria. The fact that you experienced symptoms in your palms and soles, along with tightness and pain in your fingers and toes, raises some concerns. These symptoms could suggest a possible inflammatory process, which may or may not be related to rheumatoid arthritis.

It is important to note that urticaria itself does not cause rheumatoid arthritis. However, individuals with autoimmune conditions may have a higher propensity for allergic reactions or skin issues due to their immune system's dysregulation. The tightness and pain in your fingers and toes, especially if they are accompanied by stiffness, could indicate an inflammatory response that warrants further investigation.

Given your symptoms, it would be prudent to consult a rheumatologist or an immunologist for a thorough evaluation. They may recommend blood tests to check for markers of inflammation, such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), as well as specific autoantibodies associated with rheumatoid arthritis, such as rheumatoid factor (RF) and anti-citrullinated protein antibodies (anti-CCP).
In terms of your academic pursuits, it is essential to prioritize your health. If your symptoms are significantly impacting your ability to concentrate or perform daily activities, it may be wise to consider a temporary break or reduced course load until you have a clearer understanding of your health status. Stress can exacerbate both allergic reactions and autoimmune conditions, so managing your workload and ensuring adequate rest is crucial.

In summary, while urticaria does not directly cause rheumatoid arthritis, the symptoms you are experiencing could be indicative of an underlying inflammatory process. It is essential to seek medical advice for a comprehensive evaluation and to determine the best course of action for your health and academic commitments. Remember, early intervention can lead to better management of potential autoimmune conditions and improve your overall quality of life.

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