A 43-year-old man has hives, swelling of the face, and abdominal pain. Let’s diagnose.

A 43-year-old man presented to the emergency room with hives, swelling of the face, and abdominal pain that developed a few hours after a steak meal.  On examination, urticarial plaques were seen on the patient’s trunk and arms. Additionally, edema of the face and tongue were seen. On further questioning, the patient mentioned that he frequently hiked and recalled removing several ticks over the years. Some of these tick bites had led to very itchy reactions recently.  The patient did not have a history of allergic conditions and was not currently taking any medications.

What’s the diagnosis?

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