Cold urticaria in children may be the cause of anaphylaxis: Clinical findings of our patients

Abstract

Background. – Cold urticaria (ColdU) is a subtype of chronic inducible urticaria. Although cold urticaria is rare in children, it has a special importance because it can result in anaphylaxis. Since it is difficult to protect patients from cold for many years, the prognosis of the disease is curious. Objective. – We aimed to evaluate the clinical features and prognosis of children with cold urticaria. Methods. – Patients with cold urticaria who were followed up in our pediatric allergy and immunology clinic between 2006 and 2020 were retrospectively evaluated. The reaction was divided into three groups according to the severity of symptoms: type 1; urticaria and/or angioedema at the contact site; type 2; diffuse urticaria and/or angioedema without other systemic symptoms; and type 3; other systemic reactions compatible with anaphylaxis. Results. – Our study included 21 patients, 52.4% of whom were male, with a mean age at diagnosis of 10.8 ± 4.3 years (4–18 years). The median follow-up period of the patients was 36 months (24–62 months). Localized cold urticaria was detected in 57.1% of the cases. Type 2 reaction was found in 14.3% of the cases and Type 3 reaction was found in 28.6%. In 6 cases, there was a history of anaphylaxis (Type 3). Remission developed in four (19%) patients, symptoms decreased in 6 (28.6%) patients, and symptoms persisted in 9 (42.9%) patients. Conclusion. – Children with cold urticaria are at high risk of systemic reactions and unfortunately the disease tends to persist. Detailed guidelines are needed for follow-up and treatment considering that elimination is very difficult in children.