Cold-induced anaphylaxis (ColdA) was common in patients with typical cold urticaria (ColdU), according to findings published in Allergy. Researchers performed an international, cross-sectional study at 32 urticaria centers, obtaining a detailed history and conducting cold stimulation testing (CST). ColdA was defined as acute cold-induced involvement of the skin and/or visible mucosal tissue and at least one of the following: cardiovascular manifestations, difficulty breathing, or gastrointestinal symptoms. Among 551 patients, 75% had a positive CST; ColdA occurred in 37%. Cold-induced generalized wheals, angioedema, acral swelling, oropharyngeal/laryngeal symptoms, and earlobe itch were identified as signs/symptoms of severe disease. ColdA was most frequently triggered by total cold-water immersion and ColdA caused by cold air was more common in countries with a warmer climate. Concomitant chronic spontaneous urticaria (CSU) was noted in 10% of typical ColdU patients; they had a lower frequency of ColdA than those without CSU (4% vs 39%; P=0.003). High-risk patients should receive education about the condition and use of an adrenaline autoinjector, according to the investigators.
