Cold contact urticaria: association of positive ice cube test and autoimmunity
Saturday, March 3, 2018
South Hall A2 (Convention Center)
Rebeca M. Brugnolli, Pamella Diogo Salles, Larissa P Cau, MD, Raisa B Castro, Jorge Elias Kalil Filho, MD, PhD, Antonio Abilio Motta, Rosana C. Agondi, MD, PhD
RATIONALE: Cold contact urticaria (CCU) is a subtype of inducible urticaria that rapidly develops erythema, wheals and prurituswhen skin is exposed to cold stimulus. Unlike CCU, systemic cold urticaria might be associated to infections (such as hepatitis, parasites, bacterial infections), cryoglobulinemia, autoimmunity, and vasculitis. Patients with CCU are at risks of severe systemic reactions when exposed to immersion into cold water.

METHODS: Retrospective study of medical records of adults patients with CCU. Ice cube test was indicated for all patients with a suspected history of cold urticaria. Some of them were submitted to serum cryoglobulin, hepatitis B and C serology and autoantibodies investigation.

RESULTS: A total of 28 patients with cold urticaria were included, the mean age was38.8 years, mean time of disease was 9 years and78.6% were female. Ice cube test was performed in all but one patient, and it was positive in 72% of them. The test was not performed in one patient due to antihistamine and corticosteroid use. Cryoglobulin was performed in 7 patients; all of thempresented negative results. Autoimmunity disease or autoantibodies were present in 35% of the patients.Of these patients with autoimmune disorders, 85.7% had ice cube test positive. Only 1 patient presented positive serology to hepatitis C.

CONCLUSIONS: In this review, we highlight the importance of investigating autoimmunity disorders in patients with cold urticaria,besides infections diseases and cryoglobulin. Patients with a suggestive history of cold urticaria and a negative ice cube test may be assessed for atypical cold urticaria.