TY - JOUR

T1 - Risk factors for systemic reactions in typical cold urticaria

T2 - Results from the COLD-CE study

AU - Bizjak, Mojca

AU - Košnik, Mitja

AU - Dinevski, Dejan

AU - Thomsen, Simon Francis

AU - Fomina, Daria

AU - Borzova, Elena

AU - Kulthanan, Kanokvalai

AU - Meshkova, Raisa

AU - Ahsan, Dalia Melina

AU - Al-Ahmad, Mona

AU - Altrichter, Sabine

AU - Bauer, Andrea

AU - Brockstädt, Maxi

AU - Costa, Célia

AU - Demir, Semra

AU - Fachini Criado, Roberta

AU - Ensina, Luis Felipe

AU - Gelincik, Asli

AU - Giménez-Arnau, Ana Maria

AU - Gonçalo, Margarida

AU - Gotua, Maia

AU - Holm, Jesper Grønlund

AU - Inomata, Naoko

AU - Kasperska-Zajac, Alicja

AU - Khoshkhui, Maryam

AU - Klyucharova, Aliya

AU - Kocatürk, Emek

AU - Lu, Rongbiao

AU - Makris, Michael

AU - Maltseva, Natalya

AU - Miljković, Jovan

AU - Pasali, Maria

AU - Paulino, Marisa

AU - Pesqué, David

AU - Peter, Jonny

AU - Ramón, German Dario

AU - Ritchie, Carla

AU - Rodrigues Valle, Solange Oliveira

AU - Rudenko, Michael

AU - Sikora, Agnieszka

AU - de Souza Lima, Eduardo M.

AU - Wagner, Nicola

AU - Xepapadaki, Paraskevi

AU - Xue, Xiaoyang

AU - Zhao, Zuotao

AU - Terhorst-Molawi, Dorothea

AU - Maurer, Marcus

N1 - Publisher Copyright: © 2021 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.

PY - 2022/7

Y1 - 2022/7

N2 - 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.

AB - 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.

KW - adrenaline autoinjector

KW - cold urticaria

KW - COLD-CE

KW - risk factors

KW - systemic reactions

UR - http://www.scopus.com/inward/record.url?scp=85121601539&partnerID=8YFLogxK

U2 - 10.1111/all.15194

DO - 10.1111/all.15194

M3 - Journal article

C2 - 34862605

AN - SCOPUS:85121601539

VL - 77

SP - 2185

EP - 2199

JO - Allergy: European Journal of Allergy and Clinical Immunology

JF - Allergy: European Journal of Allergy and Clinical Immunology

SN - 0105-4538

IS - 7

ER -