Cold Urticaria: Release into the Circulation of Histamine and Eosinophil Chemotactic Factor of Anaphylaxis during Cold Challenge

TLDR

Patients with idiopathic cold urticaria had one arm immersed in ice water while the other served as control, and serial blood samples were collected over one hour to assay histamine, eosinophil chemotactic factor of anaphylaxis, and complement components. Histamine and eosinophil chemotactic factor rose in the cold‑immersed arm within three minutes, peaked between two and five minutes, and returned to baseline by 30 minutes, with no changes in the control arm or in normal subjects and normal complement pathways, indicating a central mast‑cell role in cold urticaria.

Abstract

Patients with idiopathic acquired cold-induced urticaria were evaluated for the release of the preformed mast-cell mediators of immediate-type hypersensitivity during a study in which one arm was immersed in ice water while the other arm remained as a control. Blood specimens were obtained from each arm serially over a one-hour interval, and serum speciments were assessed for histamine, eosinophil chemotactic factor of anaphylaxis, and complement components. Levels of histamine and eosinophil chemotactic factor rose in the arm subjected to cold immersion for three minutes, with peak values occurring between two and five minutes and returning to base line by 30 minutes. No changes occurred in the control arm or in the immersed arm of normal subjects. Assessment of the classical and alternative complement pathways showed no abnormalities. This initial observation of release of eosinophil chemotactic factor of anaphylaxis in vivo along with histamine assigns the mast cell a central role in cold urticaria.