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Related Experiment Video

Updated: Jan 16, 2026

Measuring Local Anaphylaxis in Mice
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Cold Urticaria: From Wheals to Anaphylaxis.

Mojca Bizjak1,2,3

  • 1Division of Allergy, University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia.

Allergy, Asthma & Immunology Research
|October 4, 2025
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Summary

Cold urticaria (ColdU) causes hives and swelling from cold exposure. While antihistamines help, severe cold-induced anaphylaxis (ColdA) requires adrenaline and further research into its mast cell activation mechanisms.

Keywords:
Anaphylaxisangioedemaantihistaminescold urticariaskin testsurticariawheals

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Area of Science:

  • Immunology
  • Dermatology
  • Allergology

Background:

  • Cold urticaria (ColdU) involves cold-triggered wheals/angioedema, with a subset experiencing life-threatening cold-induced anaphylaxis (ColdA).
  • Mast cell activation is central to ColdU pathogenesis, though mechanisms require further investigation.
  • Current diagnostic methods like cold stimulation testing (CST) may not always align with clinical presentation.

Purpose of the Study:

  • To review the pathophysiology, classification, diagnosis, and management of ColdU and ColdA.
  • To highlight the clinical variability and identify unmet research needs in these conditions.

Main Methods:

  • Review of existing literature on cold urticaria and cold-induced anaphylaxis.
  • Analysis of diagnostic approaches including clinical history and cold stimulation testing.
  • Summary of current and emerging treatment strategies.

Main Results:

  • ColdU presents with diverse clinical manifestations and is classified based on CST responses.
  • ColdA is associated with oropharyngeal angioedema and triggered by full-body cold exposure.
  • Effective management includes H₁-antihistamines, omalizumab for refractory cases, and adrenaline for ColdA.

Conclusions:

  • Accurate diagnosis requires integrating clinical history, CST, and assessment for systemic involvement.
  • Optimal treatment involves tailored pharmacotherapy and emergency preparedness for anaphylaxis.
  • Further research is crucial to elucidate underlying mechanisms and improve patient outcomes.