Cold Stimulation Test and Histamine Release in Primary Acquired Cold Urticaria

Abstract

The patient was a 10-year-old boy who complained of urticaria upon exposure to cold air and after swimming in the pool. He also had seasonal asthma and wheezing after strenuous activities. To determine whether he had primary acquired cold urticaria, we performed a cold stimulation test twice. We likewise wanted to know whether a difference in response with regard to histamine release existed between blood samples taken from the challenged and the unchallenged sites. We obtained blood samples for histamine release initially at the site opposite the challenged forearm, and then on the same side on two separate occasions. We noted the appearance of constitutional signs and symptoms and correlated the time of their appearance with the result of histamine levels. The patient complained of pruritus and wheals appeared at the 5 minute in both tests. Results of plasma histamine release in the two measurements showed the highest releasability at 15 min. Our findings revealed that histamine is released systemically in response to cold stimulation regardless of the site where the blood sample was obtained.

Temperature Thresholds in Assessment of the Clinical Course of Acquired Cold Contact Urticaria: A Prospective Observational One-year Study

“…Symptoms are usually limited to coldexposed skin areas, but extensive cold contact may result in generalized symptoms, such as headache, dyspnoea, hypotension and loss of consciousness (5,6). Hives are caused by histamine (7)(8)(9)(10) and other mediators, such as platelet-activating factor (PAF) and cytokines released from activated mast-cells, after exposure to cold triggering factors (1,2,(11)(12)(13)(14)(15)(16). To confirm the diagnosis cold stimulation standardized tests are mandatory.…”

Urticaria por frío: serie de casos y revisión del tema

“…Lo que sí está más claro es que, cuando las inmunoglobulinas anti-IgE se unen a su blanco en la membrana de los mastocitos, se inicia la cascada inflamatoria que resulta en la liberación de la histamina y de otros mediadores (39). Estudios más recientes han demostrado que, además de los anticuerpos anti-IgE, también hay anticuerpos que reaccionan contra el receptor de alta afinidad de la IgE (FceR1) en 30 a 40 % de los pacientes con urticaria idiopática crónica y, posiblemente, en la urticaria por frío (40).…”

Classification of Exogenous Factors Contributing to the Itch Response

“…That is, an urticarial reaction that occurs in some persons when exposed to cold temperatures. As with other urticarial reactions, it is believed to be caused by histamine release, though the exact mechanism leading to the histamine release is poorly understood [16] . Heat urticaria is a rare clinical syndrome caused by exposure to a warm stimulus.…”