20.500.12556/DKUM-82790 Risk factors for systemic reactions in typical cold urticaria results from the COLD-CE study Background: Cold urticaria (ColdU), i.e. the occurrence of wheals or angioedema in response to cold exposure, is classified into typical and atypical forms. The diagnosis of typical ColdU relies on whealing in response to local cold stimulation testing (CST). It can also manifest with cold-induced anaphylaxis (ColdA). We aimed to determine risk factors for ColdA in typical ColdU. Methods: An international, cross-sectional study COLD-CE was carried out at 32 urticaria centers of reference and excellence (UCAREs). Detailed history was taken and CST with an ice cube and/or TempTest® performed. ColdA was defined as an acute cold-induced involvement of the skin and/or visible mucosal tissue and at least one of: cardiovascular manifestations, difficulty breathing, or gastrointestinal symptoms. Results: Of 551 ColdU patients, 75% (n=412) had a positive CST and ColdA occurred in 37% (n=151) of the latter. Cold-induced generalized wheals, angioedema, acral swelling, oropharyngeal/laryngeal symptoms, and itch of earlobes were identified as signs/symptoms of severe disease. ColdA was most commonly provoked by complete cold water immersion and ColdA caused by cold air was more common in countries with a warmer climate. Ten percent (n=40) of typical ColdU patients had a concomitant chronic spontaneous urticaria (CSU). They had a lower frequency of ColdA than those without CSU (4% vs 39%, p=0.003). We identified the following risk factors for cardiovascular manifestations: previous systemic reaction to a Hymenoptera sting, angioedema, oropharyngeal/laryngeal symptoms, and itchy earlobes. Conclusion: ColdA is common in typical ColdU. High-risk patients require education about their condition and how to use an adrenaline autoinjector. adrenaline autoinjector cold urticaria COLD-CE risk factors systemic reactions epinephrine therapeutic use self administration injections intramuscular methods adrenalinski avtoinjektor hladna urtikarija dejavniki tveganja sistemske reakcije koprivnica urtikarija adrenalin urtikarija zaradi mraza terapevtska raba avtoadministracija intramuskularne injekcije metode true false true Wiley Angleški jezik Slovenski jezik Znanstveno delo 2022-09-02 10:28:11 2024-08-06 15:18:14 2024-08-07 03:41:17 0000-00-00 00:00:00 2022 0 0 Str. 2185-2199 Št. 7 Letn. 77 Jul. 2022 0000-00-00 Zaloznikova Objavljeno NiDoloceno 2021-10-12 2021-11-20 2021-12-04 616-097 88071683 10.1111/all.15194 1398-9995 Bizjak-2022-Risk_factors_for_systemic_reaction.pdf Bizjak-2022-Risk_factors_for_systemic_reaction.pdf 1 7101DBC8557F6B04FDC63363C2E1DFFC 2ff97d677e47ebb90eec88eebfaef37493b70889e3939892d7d35b0bf5d10525 388f15c5-53f6-11ef-82b3-00155d000105 https://dk.um.si/Dokument.php?lang=slv&id=182057 https://doi.org/10.1111/all.15194 0 2eaa5992-2a99-11ed-9218-00155d000105 https://dk.um.si/Dokument.php?lang=slv&id=161585 Medicinska fakulteta 0 0 0