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Risk factors for systemic reactions in typical cold urticaria: Results from the COLD‐CE study
Author(s) -
Bizjak Mojca,
Košnik Mitja,
Dinevski Dejan,
Thomsen Simon Francis,
Fomina Daria,
Borzova Elena,
Kulthanan Kanokvalai,
Meshkova Raisa,
Ahsan Dalia Melina,
AlAhmad Mona,
Altrichter Sabine,
Bauer Andrea,
Brockstädt Maxi,
Costa Célia,
Demir Semra,
Fachini Criado Roberta,
Ensina Luis Felipe,
Gelincik Asli,
GiménezArnau Ana Maria,
Gonçalo Margarida,
Gotua Maia,
Holm Jesper Grønlund,
Inomata Naoko,
KasperskaZajac Alicja,
Khoshkhui Maryam,
Klyucharova Aliya,
Kocatürk Emek,
Lu Rongbiao,
Makris Michael,
Maltseva Natalya,
Miljković Jovan,
Pasali Maria,
Paulino Marisa,
Pesqué David,
Peter Jonny,
Ramón German Dario,
Ritchie Carla,
Rodrigues Valle Solange Oliveira,
Rudenko Michael,
Sikora Agnieszka,
Souza Lima Eduardo M.,
Wagner Nicola,
Xepapadaki Paraskevi,
Xue Xiaoyang,
Zhao Zuotao,
TerhorstMolawi Dorothea,
Maurer Marcus
Publication year - 2022
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/all.15194
Subject(s) - angioedema , medicine , dermatology , anaphylaxis , common cold , allergy , erythema , concomitant , immunology
Background Cold urticaria (ColdU), that is, the occurrence of wheals or angioedema in response to cold exposure, is classified into typical and atypical forms. The diagnosis of typical ColdU relies on whealing in response to local cold stimulation testing (CST). It can also manifest with cold‐induced anaphylaxis (ColdA). We aimed to determine risk factors for ColdA in typical ColdU. Methods An international, cross‐sectional study COLD‐CE was carried out at 32 urticaria centers of reference and excellence (UCAREs). Detailed history was taken and CST with an ice cube and/or TempTest ® performed. ColdA was defined as an acute cold‐induced involvement of the skin and/or visible mucosal tissue and at least one of: cardiovascular manifestations, difficulty breathing, or gastrointestinal symptoms. Results Of 551 ColdU patients, 75% ( n = 412) had a positive CST and ColdA occurred in 37% ( n = 151) of the latter. Cold‐induced generalized wheals, angioedema, acral swelling, oropharyngeal/laryngeal symptoms, and itch of earlobes were identified as signs/symptoms of severe disease. ColdA was most commonly provoked by complete cold water immersion and ColdA caused by cold air was more common in countries with a warmer climate. Ten percent ( n = 40) of typical ColdU patients had a concomitant chronic spontaneous urticaria (CSU). They had a lower frequency of ColdA than those without CSU (4% vs. 39%, p = .003). We identified the following risk factors for cardiovascular manifestations: previous systemic reaction to a Hymenoptera sting, angioedema, oropharyngeal/laryngeal symptoms, and itchy earlobes. Conclusion ColdA is common in typical ColdU. High‐risk patients require education about their condition and how to use an adrenaline autoinjector.