Cold Urticaria (Severe Allergic Reaction To Cold)

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Man dreads winter as single snowflake could kill him
Shop worker is allergic to the cold and his reactions are so bad he can even go into a life-threatening anaphylactic shock
By News agencies
9:18AM GMT 25 Nov 2013

A shop worker is dreading winter because an allergy to the cold means that even a single snowflake could kill him.
Bernard Ward's skin explodes into angry hives if he comes into contact with anything cold – from a snowflake to a cold pint of beer. :shock:
And the reactions can be so bad that he can even go into a life-threatening anaphylactic shock.

Medics believe that Mr Ward developed the condition after standing at a bus stop in temperatures of -10 in Scotland, in 2012.
He now has to wrap up warm even indoors – and does not dare venture outside in particularly cold weather.
Even the gym is out of bounds because the air con could trigger a deadly reaction.

Mr Ward, from Derry, Northern Ireland, said:"I dread winter coming – I know most people don't like the cold but it could be deadly for me.
"It costs me a fortune in heating bills and thick clothes, but I have no other choice.
"Since I developed the allergy, it's totally changed my life. A simple night out with my mates down the pub is out of the question."

Bernard first noticed some aggravation to the cold while commuting to Belfast in winter 2011, but wasn't diagnosed with Cold Urticaria for four months.
He said: "Every time I was waiting for the bus my hands began to itch really badly, and burn as if I had put them in a pile of nettles.
"I thought nothing of it and got on with things and hoped it would go away.

"My GP said it was probably a reaction to washing powder, or something I'd eaten, but in February 2012, I was on a three-week course in Scotland.
"On my first evening there, it was about -10, and I was waiting on a bus to take me back to the hotel and I wasn't wearing any gloves and I was carrying bags.
"After a few minutes my fingers and hands began to swell up so badly I couldn't bend them.

"My face also was burning and itching and I was wheezing. I got to the hotel room, after changing out of my clothes into something warmer, I noticed my thighs had swollen and were covered in huge welts too."
It was only then that doctors diagnosed him with a severe allergy to the cold.

Bernard added: "At the time, I worked in a busy retail store, the air conditioning was on for about an hour and I just didn't feel well and couldn't work out why.
"I remember feeling like I was going to faint and I was having the most uncomfortable heart palpitations.
"I went out the back to sit down for a bit and noticed my hands were covered in hives.
"I wrapped up took antihistamines and went home. After this I was referred to a specialist."

It was confirmed by a hospital specialist that Bernard was suffering from Cold Urticaria a type of allergy that causes the body to react badly to not only touching anything cold but also sudden drops in temperature.
He said: "Initially it got me very down and anxious. I could not understand what was happening to me and I kept thinking that it would go away soon.
"I gradually stopped doing everyday things like going to the gym as the air conditioning affected me.
"I could no longer play football as playing outdoors gave me bad reactions and socialising became a nightmare.
"Having cold drinks made my throat swell and even holding a pint of cold beer on a night out made my hand swell up.
"I have to wear ridiculous amounts of clothes in the winter.
"Financially this can be tough too with transport costs, clothing costs and fuel bills."

Although the condition has had a massive impact on his life and those closest to him, Bernard says he has amazing support from his family including his fiancé Mairead who he hopes to marry next year.
"My fiancé has been great. She adapted really well to my condition and gives me support every day.
"At first things were tough and they still are as we can no longer do outdoor things like going for a walk.

"Going out at night is not an easy task either as we have to plan in advance and have taxi pick us up then leave early as to not be standing in a taxi queue at night.
"It took people a while to realise the extent of it and people do still forget themselves sometimes and ask me to do things which I just can't do anymore."

At present there is no known cure for Cold Urticaria but it can be managed through the use of antihistamines and keeping as warm as possible.

http://www.telegraph.co.uk/health/10472 ... l-him.html
 

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Man dreads winter as single snowflake could kill him
Shop worker is allergic to the cold and his reactions are so bad he can even go into a life-threatening anaphylactic shock

... At present there is no known cure for Cold Urticaria but it can be managed through the use of antihistamines and keeping as warm as possible. ...

Here's a new report of severe cold urticaria. In this case the victim collapsed, went into anaphylactic shock and had to be hospitalized.
Man almost dies from an allergic reaction to cold air

Stepping out of a hot shower into a cold bathroom almost killed a Colorado man, who had developed a serious allergic reaction to cold temperatures.

The 34-year-old old man collapsed after getting out of the shower, and his family found him on the floor, according to a report of the case published Oct. 27 in The Journal of Emergency Medicine. The man was struggling to breathe and his skin was covered in hives. He was experiencing a life-threatening, whole-body allergic reaction known as anaphylaxis.

When paramedics arrived, his family told them that the man had a history of being "allergic to the cold weather," according to the report. He had previously experienced hives as a reaction to the cold, but not anaphylaxis. These episodes started after he moved from Micronesia, which has a tropical climate, to Colorado, which sees colder temperatures, the report said. ...

Doctors diagnosed him with cold urticaria, an allergic reaction of the skin after exposure to cold temperatures, including cold air or cold water, according to the Mayo Clinic. People can also develop symptoms after consuming cold food or drinks ...

Exactly how common the condition is overall is not known — one study in Europe found a prevalence of 0.05%, according to the National Institutes of Health. Anaphylactic reactions are less common than hive-like reactions.

In most cases, the cause of the condition is not known, but sometimes it can be inherited, meaning people have a genetic predisposition. In other people, cold urticaria is triggered by something that affects the immune system, such as a viral infection or certain cancers.

The allergic reaction happens because exposure to the cold causes the immune system to release chemicals called histamines, which trigger an inflammatory response ...

FULL STORY: https://www.livescience.com/cold-allergy-urticaria-anaphylaxis.html
 

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Here are the bibliographic details and abstract from the published paper on the recent Colorado case.

Cold Anaphylaxis: A Case Report
Cody Brevik, MD and Matthew Zuckerman, MD
The Journal of Emergency Medicine
Published:October 27, 2020

DOI:https://doi.org/10.1016/j.jemermed.2020.09.032
Abstract

Background

Cold anaphylaxis is a severe form of hypersensitivity reaction to cold temperatures. Such reactions include a spectrum of presentations that range from localized symptoms to systemic involvement. The condition can be acquired or heritable, although it may also be idiopathic. Treatment consists of second-generation H 1 antihistamines, epinephrine, and supportive care. Prevention involves avoidance of known triggers, most commonly cold immersion due to environment or water exposure.

Case Report
We report the case of a 34-year-old man with cold-induced urticaria/anaphylaxis who presented to our emergency department with hypotension and shortness of breath after exposure to cold air after getting out of a shower. He required two doses of intramuscular epinephrine and was ultimately started on an epinephrine infusion. He was admitted to the intensive care unit for anaphylaxis monitoring and was found to have a positive ice cube test, reinforcing the suspected diagnosis.

Why Should An Emergency Physician Be Aware of This?
Cold anaphylaxis is a potentially life-threatening phenomenon with specific testing. It is occasionally described in the emergency medicine literature. Providers should be aware of the potential for cold anaphylaxis as it can change patient guidance and alter management. This condition can also contribute to otherwise unclear and sudden decompensation in critically ill patients, as has been reported in cases of cold anaphylaxis induced by cold IV infusions.

SOURCE: https://www.jem-journal.com/article/S0736-4679(20)30968-9/fulltext
 

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This 2018 Live Science article describes a woman who experienced a cold urticaria attack after her co-workers cranked up the air conditioning in their workplace.
Why One Woman Broke Out in Hives When Her Co-Workers Cranked Up the AC

It all started when a woman's co-workers ramped up the air conditioning. For some reason, she broke out in hives. Concerned, the woman visited the doctor and got startling news: She was allergic to the cold.

The condition, known as cold urticaria (ur-tih-KAR-ee-uh), is rare, but it jibed with her past experiences, the woman's doctors wrote in a new Australian case report ... The 40-year-old woman said she also got hives on windy days, while walking outside on cold mornings and after swimming in the ocean.

The latest episode was brought on because her co-workers, who were experiencing menopausal hot flashes, had cranked up the AC in the office, her doctors found. ...

People with cold urticaria can also break out in hives if they come into contact with cold objects or consume cold foods or drinks, the doctors wrote. In fact, while examining the woman, the doctors pressed an ice cube against her arm for 10 minutes. After removing the ice, they saw a "well-defined wheal, consistent with the diagnosis of cold urticaria," the doctors wrote in the case report. ...

It's unclear what causes cold urticaria, but sometimes it's triggered by certain blood cancers and autoimmune diseases, said Dr. Tho Truong, an allergist at National Jewish Health in Denver who was not involved with the patient's care. In the woman's case, it's possible she inherited a trait that made her susceptible to the condition, as her mother has a similar, but milder, reaction to cold temperatures, the doctors wrote in the case report. ...

FULL STORY: https://www.livescience.com/62422-cold-allergy-urticaria.html
 

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Here are the bibliographic details and abstract for the case report published about the 2018 incident.

An unusual hazard of menopause in the workplace: a case report
B. G. A. Stuckey & M. S. Stuckey
Climacteric
Volume 21 (2018), Issue 3
Pages 303-304
Published online: 03 Apr 2018
https://doi.org/10.1080/13697137.2018.1455658

Abstract
Untreated vasomotor symptoms of the menopause can have a major impact on women at work. Recent recommendations advocate modification of the working environment, including adequate air-conditioning, to help relieve these symptoms. However, this may cause discomfort for work colleagues. We report the case of a 40-year-old woman with cold urticaria. Cold urticaria is a serious, potentially life-threatening condition. Our patient’s symptoms were exacerbated when her postmenopausal work colleagues turned the air-conditioner temperature down to relieve their vasomotor symptoms

SOURCE: https://www.tandfonline.com/doi/abs/10.1080/13697137.2018.1455658?journalCode=icmt20&
 
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