IGHE and urticaria: It is an acute, potentially fatal, systemic reaction in which our body responds to some allergens which are usually due to IgE-mediated hypersensitivity reactions resulting from crosslinking of allergen-specific IgE molecules on mast cells or basophils.2 The common clinical features patient presents with are urticaria, flushing, pruritis with rashes, difficulty in breathing, hypotension, syncope, dizziness, and other systemic manifestations.3 The signs and symptoms usually develop within a few minutes of exposure to the offending agent but can be as late as one hour of post-exposure.4