Alan A Wanderer

We investigated the possibility that the inflammatory reaction in primary acquired cold urticaria might be associated with the release of platelet-activating factor. Six patients with the disease and five normal controls were subjected to cold-water challenges during which blood samples were obtained for measurement of the release of possible mediators: i.e., histamine, neutrophilic chemotactic activity, and platelet-activating factor-like lipid (PAF-LL). Four of the patients had ...

The acquired cold urticaria (ACU) syndromes consists of nonfamilial heterogeneous disorders characterized by urticaria, angioedema, and occasionally symptoms of hypotension after cold exposure. In a study of 50 consecutive patients with ACU syndromes, it was observed that 70% experienced cold-induced systemic reactions, most frequently with aquatic activities. Patients with ACU syndromes were categorized by their response to an experimental cold-stimulation time test (CSTT) i.e., minimum ...

Serum factors from 2 patients with primary acquired cold urticaria have been characterised. These serum factors, which can passively transfer cold urticaria to normal recipients, are low in titer, have short skin-fixation times, and are relatively thermostable. Reduction with dithiothreitol or mercaptoethanol followed by alkylation with iodoacetamide destroyed the cold urticaria transfer activity. The passive transfer factor in both cases was recovered in Sephadex G-200 gel filtration ...

Eight subjects with primary-acquired cold urticaria were treated with chlorpheniramine maleate, cyproheptadine hydrochloride, and placebo in a double-blind clinical trial. During three separate seven-day treatment periods, each patient took 4 mg of either active drug or lactose placebo three times a day. Objective measurements were made at the beginning and end of each treatment period by establishing the minimum time (MT) of cold stimulus application required to provoke urtication. In ...

We have been able to effectively treat cold-induced urticaria with cyproheptadine. In 8 of 9 patients with primary acquired cold urticaria treated with this drug, there was a striking prolongation of the minimum time required for the induction of a wheal with a cold stimulus. Concomitant with this change there was a significant reduction or elimination of cold sensitivity following natural exposure. The one treatment failure occurred in a patient with an atypical familial form of cold ...

This study describes an 11-year-old Caucasian girl with a nonfamilial, late-onsetimmunologic disorder characterized by hypogammaglobulinemia, absent anamnestic responses to previously recognized antigens, and deficient cellular immunity. Evidence for impaired cellular immunity initially included lymphopenia, absent delayed skin responses to numerous antigens and failure to develop contact hypersensitivity to dinitrofluorobenzene (DNFB), delayed skin homograft rejection, and absent in ...

In Reply.— My reply to Dr Ramsay's comment is based primarily on the well-observed fact that acquired cold urticaria may induce serious anaphylactoid reactions. In one series, Horton et al1 described a 50% incidence of systemic reactions with syncope; 40% occurred while the persons were swimming and 18% of the persons had to be rescued during aquatic activities. Since cold urticaria must be viewed as a disorder with potential risk, it is imperative that the choice of treatment be ...