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Hives frequently occur following an infection or as a result of an allergic reaction such as to medication, insect bites, or food. Psychological stress, cold temperature, or vibration may also be a trigger. In half of cases the cause remains unknown. Risk factors include having conditions such as hay fever or asthma.
Amongst the many possible causes of acute hives those due to allergic reactions get the most attention. In allergic patients the mast cells are coated with an allergy antibody, called IgE, that recognizes a very specific target (peanut, penicillin, yellow jacket, etc.).