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Related Experiment Video

Updated: Nov 28, 2025

Basophil Activation Test for Allergy Diagnosis
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Cold urticaria - What we know and what we do not know.

Natalya Maltseva1, Elena Borzova2, Daria Fomina1,3

  • 1Center of Allergy and Immunology, Clinical State Hospital 52, Moscow Ministry of Healthcare, Moscow, Russian Federation.

Allergy
|November 29, 2020
PubMed
Summary

Cold urticaria (ColdU) causes hives and swelling after cold exposure. Current treatments include antihistamines and omalizumab, but future research is needed to address knowledge gaps in its causes and management.

Keywords:
cold stimulation testingcold urticariacryoglobulinemic vasculitiscryoglobulinsfamilial cold autoinflammatory syndrome

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Area of Science:

  • Immunology
  • Dermatology

Background:

  • Cold urticaria (ColdU) is a chronic inducible urticaria triggered by cold exposure.
  • Pathophysiology involves cold-induced autoallergens, IgE, and mast cell degranulation.
  • ColdU presents with typical and atypical subtypes, with symptoms appearing upon rewarming.

Purpose of the Study:

  • To review current knowledge of ColdU.
  • To identify unanswered questions regarding ColdU's epidemiology, pathomechanisms, clinical features, and treatment.
  • To guide future research for improved ColdU management.

Main Methods:

  • Review of recent research and guideline updates on ColdU.
  • Analysis of diagnostic approaches, including patient history and cold stimulation testing.
  • Evaluation of current management strategies, including cold avoidance, antihistamines, and omalizumab.

Main Results:

  • ColdU diagnosis relies on history and cold stimulation; further tests are indicated only if clinically suggested.
  • Management includes cold avoidance, antihistamines, and off-label omalizumab.
  • Significant knowledge gaps remain concerning ColdU's epidemiology, mechanisms, heterogeneity, and treatment efficacy.

Conclusions:

  • Understanding of ColdU pathophysiology and management has advanced.
  • Further research is crucial to address remaining questions and optimize patient care.
  • Future studies should focus on closing knowledge gaps to improve ColdU outcomes.