Cold urticaria associated with immunoglobulin M serum factor

Area of Science:

• Immunology
• Dermatology

Background:

• Cold urticaria is a rare condition characterized by hives upon cold exposure.
• The specific immunological mechanisms underlying cold urticaria are not fully understood.
• Immunoglobulin M (IgM) has been implicated in some cases of cold urticaria.

Observation:

• A case of cold urticaria is presented, with suspected involvement of IgM.
• Passive transfer (PT) studies were conducted using patient serum fractions.
• Skin adhesion time was recorded, and in vivo histamine release was monitored during cold challenge.

Findings:

• Passive transfer activity was detected in cryoglobulin-free serum and IgM-containing fractions (Fraction I).
• PT tests remained positive after absorption with cold agglutinins and heat treatment of serum.
• PT tests were negative with cryoglobulin and after absorption with anti-IgM antibodies, confirming IgM's role.

Implications:

• This case supports the role of IgM as the causative agent in certain cold urticaria presentations.
• Understanding the specific immunoglobulin involved aids in accurate diagnosis and targeted treatment.
• Antihistamine therapy demonstrated efficacy in managing cold urticaria symptoms in this patient.