How is urticaria managed in children?

Q: My nephew is ten years old. Two years after his birth he got an urticaria attack. After that he used to get it twice a year during weather changes. We started homeopathic treatment and the intensity and frequency got reduced for some time. The attack is generally accompanied by fever, which at times very high along with throat infection. He had a severe attack a month ago. The doctor suggested some tests and the reports showed: Blood test-band cells 6%, Westergen 22mm(1hr), Basophils 0.4%, Creatinine 1mg/dl, Creatine Kinase (CPK) 61 U/L, anti Streptolysin O 167.00 IU/ml, C-Reactive Protein 8.4 mg/dl, Urine Protein (Albumin) present 1+ (30.0mg/dl). Doctor said that he needs complete bed rest for few days. If the problem still persists he needs to be admitted. He prescribed Celestone 0.5 mg dosage: 2mg two times a day for 5 days then 1mg 2 times a day for 2 days and subsequently reducing the dose. Kelfor 250mg (thrice a day), Practin syrup 1 teaspoon 2 times a day. Coughlet 1 teaspoon a day. Is the problem severe? Is the medicine correct? Does he require other tests?

A:Your nephew seems to be suffering from urticaria, an allergic disorder. As of now there is no permanent cure that can be offered to him, however there are many effective medicines that can help control the severity of symptoms. Since he gets these attacks about twice an year, he does not need to be put on any regular medication. Instead, he should be treated as and when symptoms arise, the drug choice, dose and duration being decided by severity of symptoms and response to medication. A short course of betamethasone (celestone) is effective in controlling symptoms if severe. Milder symptoms can be controlled by practin alone. Practin can also be given over a longer period of time since it is a very safe medicine. However, celestone is best taken for short duration. Keflor & cough syrup are for his respiratory infection and not urticaria.In most children tendency for urticaria subsides with time.