Risk factors for systemic reactions in typical cold urticaria: results from the COLD-CE study

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• dc.contributor.author Bizjak, Mojca
• dc.contributor.author Giménez Arnau, Anna Maria
• dc.contributor.author Pesqué, David
• dc.contributor.author Maurer, Marcus
• dc.date.accessioned 2022-07-15T06:56:23Z
• dc.date.available 2022-07-15T06:56:23Z
• dc.date.issued 2022
• dc.description.abstract 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.
• dc.format.mimetype application/pdf
• dc.identifier.citation Bizjak M, Košnik M, Dinevski D, Thomsen SF, Fomina D, Borzova E, et al. Risk factors for systemic reactions in typical cold urticaria: results from the COLD-CE study. Allergy. 2022 Jul; 77(7): 2185-99. DOI: 10.1111/all.15194
• dc.identifier.doi http://dx.doi.org/10.1111/all.15194
• dc.identifier.issn 0105-4538
• dc.identifier.uri http://hdl.handle.net/10230/53746
• dc.language.iso eng
• dc.publisher Wiley
• dc.rights This is the peer reviewed version of the following article: Bizjak M, Košnik M, Dinevski D, Thomsen SF, Fomina D, Borzova E, et al. Risk factors for systemic reactions in typical cold urticaria: results from the COLD-CE study. Allergy. 2022 Jul; 77(7): 2185-99, which has been published in final form at http://dx.doi.org/10.1111/all.15194 . This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.subject.keyword COLD-CE
• dc.subject.keyword Adrenaline autoinjector
• dc.subject.keyword Cold urticaria
• dc.subject.keyword Risk factors
• dc.subject.keyword Systemic reactions
• dc.title Risk factors for systemic reactions in typical cold urticaria: results from the COLD-CE study
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/acceptedVersion