Cold-induced anaphylaxis triggered by drinking cold water

• Abdulaziz S Alrafiaah ^[2] ; Elena Netchiporouk ^[1] ; Moshe Ben-Shoshan ^[2]
  1. [1] McGill University Health Centre

     McGill University Health Centre

     Canadá

     
  2. [2] Division of Pediatric Allergy and Clinical Immunology, Department of Pediatrics, McGill University Health Center, Quebec, Canada
• Localización: Allergologia et immunopathologia: International journal for clinical and investigate allergology and clinical immunology, ISSN-e 1578-1267, ISSN 0301-0546, Vol. 52, Nº. 2, 2024, págs. 45-47
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Cold urticaria is an inducible urticaria in which hives and angioedema appear after exposure to cold. The symptoms of cold urticaria often are limited to hives/angioedema. However, in up to 20% of cases, cold exposure may trigger anaphylaxis. We report the case of an 11-year-old boy previously diagnosed with chronic spontaneous urticaria who developed facial swelling, itchy hives, difficulty in breathing, vomiting and abdominal pain within 5 minutes of drinking cold water. He received a standard dose of non-sedating second-generation antihistamines at home. He was observed in the emergency room for 2 hours and discharged with an epinephrin autoinjector. During the subsequent outpatient clinic visit, an ice cube test was performed which confirmed the new diagnosis of comorbid cold-induced chronic urticaria. On further questioning, the parents reported occurrence of hives following swimming in the swimming pool. Cold-induced urticaria should be suspected in cases of anaphylaxis associated with cold exposure. Patients with chronic forms of urticaria who present with new anaphylaxis should be assessed for a potential concomitant cold-induced form.