Veröffentlichungen

Mast cell-activating signals in cold urticaria are not yet well defined and are likely to beheterogeneous. Cold agglutinins and cryoglobulins have been described as factorspossibly associated with cold urticaria, but their relevance has not been explained. Weperformed a single-center prospective cohort study of 35 cold urticaria patients. Coldagglutinin and cryoglobulin test results, demographics, detailed history data, coldstimulation test results, complete bloodcount values, C-reactive protein, totalimmunoglobulin E levels, and basal serum tryptase levels were analyzed. Forty sixpercent (n= 16) of 35 tested patients had a positive cold agglutinin test and 27% (n=9) of 33 tested patients had a positive cryoglobulin test. Cold agglutinin positive patients,when compared to cold agglutinin negative ones, were mainly female (P= 0.030). Nogender-association was found for cryoglobulins. A positive cold agglutinin test, but not apositive cryoglobulin test, was associated with a higher rate of reactions triggered by coldambient air (P= 0.009) or immersion in cold water (P= 0.041), and aggravated byincreased summer humidity (P= 0.007). Additionally, patients with a positive coldagglutinin test had a higher frequency of angioedema triggered by ingestion of coldfoods or drinks (P= 0.043), and lower disease control based on Urticaria Control Test (P=0.023). Cold agglutinin levels correlated with erythrocyte counts (r =−0.372,P= 0.028)and monocyte counts (r =−0.425,P= 0.011). Cryoglobulin concentrations correlatedwith basal serum tryptase levels (r = 0.733,P= 0.025) and cold urticaria duration (r =0.683,P= 0.042). Results of our study suggest that cold agglutinins and cryoglobulins, ina subpopulation of cold urticaria patients, are linked to the course and possibly thepathogenesis of their disease.