Case study: 24 years old woman presented with enlarged lymph nodes and severe urticarial skin reaction which started at any moving. She had virus tonsilitis and back/neck pain with high fever. In blood differential tests there was no sign of bacterial superinfection however limfocites were high and eosinophiles low. What medications/measurements do you recommend for urticarial elimination so she can at least go to work ? Have you had any case like that?
Probably it is a case of infectious mononucleosis.
Check of LDH, B2microglobolin, Ca, uric acid, LFT,ALPh, check viral markers(HBV,HCV,HIV, monospot test for EBV) and ask for B symptom(weight loss,…) , and more physical exam such as spelenomegali; hepatomegali, for R/o of lymphoma
Also check of ESR, CRP, and history of TB And ask for collagen vascular disease and vasculitis, such as LCV
So —>DDX for this case is : 1- infections( viral and TB) 2-lymphoprolifrative disorders( lymphoma) 3- collagen vascular diseases( vasculatis)
Anti histamine, corticosteroid and some emollients maybe helpful