Cold Anaphylaxis in Children: Italian Case Series and Review of the Literature

Author:

Tomei Leonardo12ORCID,Saretta Francesca3ORCID,Arasi Stefania4ORCID,Sarti Lucrezia1,Licari Amelia5ORCID,Giovannini Mattia12ORCID,Barni Simona1ORCID,Liccioli Giulia1,Tallarico Valeria6ORCID,Piccorossi Alessandra7,Caffarelli Carlo8ORCID,Novembre Elio2,Mori Francesca1

Affiliation:

1. Allergy Unit, Meyer Children’s Hospital IRCCS, 50139 Florence, Italy

2. Department of Health Sciences, University of Florence, 50139 Florence, Italy

3. Pediatric Department, Latisana-Palmanova Hospital, Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, Italy

4. Translational Research in Pediatric Specialties Area, Division of Allergy, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy

5. Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy

6. Pediatric Unit, University Hospital Renato Dulbecco, 88100 Catanzaro, Italy

7. Pediatric Unit, Bufalini Hospital, AUSL Romagna, 47521 Cesena, Italy

8. Pediatric Clinic, Medicine and Surgery Department, Azienda Ospedaliero-Universitaria, University of Parma, 43126 Parma, Italy

Abstract

Chronic urticaria (CU) is one of the most common skin disorders worldwide. Among the inducible subgroup of CU, cold urticaria (ColdU) can affect both children and adults and is the only type associated with the risk of anaphylaxis without cofactors. In the scientific literature, data about cold anaphylaxis (ColdA) are poor, especially at pediatric age, and little is known about risk factors associated with the onset of systemic reactions and about the criteria for prescribing adrenaline auto-injectors (AAIs) in these patients. We describe the clinical characteristics and management of a case series of 21 patients with a history of ColdA, and we compare them with the pediatric case reports and case series published so far. On the basis of the scientific literature and of our case series of patients, we suggest that AAI should be prescribed to all high-risk patients: those with urticaria caused by cold-water immersion, oropharyngeal reactions, and with a previous history of systemic symptoms or anaphylaxis.

Publisher

MDPI AG

Subject

General Medicine

Reference55 articles.

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2. Frank, J.P. (1792). De curandis Hominum Morbis Epitome Praelectonibus Academicis Dicata. Liber III: De Exanthematibus, Apud CF Schwan et CG Goetz Bibliop.

3. The international EAACI/GA2LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria;Zuberbier;Allergy,2022

4. Management of Pediatric Urticaria with Review of the Literature on Chronic Spontaneous Urticaria in Children;Grattan;J. Allergy Clin. Immunol. Pract.,2018

5. Cholinergic Urticaria with Anaphylaxis: An Underrecognized Clinical Entity;Vadas;J. Allergy Clin. Immunol. Pract.,2016

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