An unusual case of immediate hypersensitivity reaction to a common medication

A 31-year-old, white woman with a history of migraines was referred by an outside allergist to our allergy-immunology clinic for evaluation of urticaria and possible medication allergy. Her hives began approximately 3 months before presentation when she first noted hives on awakening. Since then, she reported having 7 to 10 outbreaks of hives, which usually occurred around the time of her menses. The patient described her hives as raised red welts, very pruritic, and lasting fewer than 24 hours.

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