Exercise-induced urticaria with muscle injury: a case report

Exercise has become an integral part of life in this modern era due to sedentary lifestyle. Although, urticaria patients are being evaluated for all the common triggering factors like food, environmental allergens and infections, entity called exercise induced often get missed. Exertional asymptomatic rhabdomyolysis must be kept mind during evaluation. A 27 year male patient was diagnosed with severe muscle injury. Patient developed within 30 minutes strenuous exercise. Clinical history insignificant any allergen exposure except clear once weekly after also reported need oral analgesics on day indicating Asymptomatic phase correlated abstinence His lesions gradually got relieved anti-histamines. Routine blood investigations were normal elevation aspartate aminotransferase (AST-354U/L), Lactate dehydrogenase (LDH-619U/L) alanine (ALT-51U/L), altered AST/ALT ratio more than 6. Creatinine kinase (CK) can increase ten folds healthy individuals following Hence, CK not done patient. Aminotransferases may remain elevated even normalisation up 2-3 weeks. LDH as additional investigation. Simple routine investigation AST confirmation or its source from injury done. Severe managed moderation intensity along short course antihistamines owing benefit This followed 2 years there no episode stepping down intensity. Detailed duration is required basic evaluating urticaria. sub-entity risk exertional rhabdomyolysis.