1. Cold agglutinins and cryoglobulins associate with clinical and laboratory parameters of cold urticariaMojca Bizjak, Mitja Košnik, Dorothea Terhorst, Dejan Dinevski, Marcus Maurer, 2021, original scientific article Abstract: Mast cell-activating signals in cold urticaria are not yet well defined and are likely to be heterogeneous. Cold agglutinins and cryoglobulins have been described as factors possibly associated with cold urticaria, but their relevance has not been explained. We performed a single-center prospective cohort study of 35 cold urticaria patients. Cold agglutinin and cryoglobulin test results, demographics, detailed history data, cold stimulation test results, complete blood count values, C-reactive protein, total immunoglobulin E levels, and basal serum tryptase levels were analyzed. Forty six percent (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). No gender-association was found for cryoglobulins. A positive cold agglutinin test, but not a positive cryoglobulin test, was associated with a higher rate of reactions triggered by cold ambient air (P = 0.009) or immersion in cold water (P = 0.041), and aggravated by increased summer humidity (P = 0.007). Additionally, patients with a positive cold agglutinin test had a higher frequency of angioedema triggered by ingestion of cold foods 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 correlated with 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, in a subpopulation of cold urticaria patients, are linked to the course and possibly the pathogenesis of their disease.
Keywords: cold-induced urticaria, cold urticaria, cryoglobulins, cold agglutinin, degranulation, clinical parameters, laboratory parameters, mast cells, cold triggers
Published in DKUM: 07.08.2024; Views: 104; Downloads: 10
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2. Risk factors for systemic reactions in typical cold urticaria : results from the COLD-CE studyMitja Košnik, Dejan Dinevski, Simon Francis Thomsen, Daria Fomina, Elena Borzova, Kanokvalai Kulthanan, Raisa Meshkova, Dalia Melina Ahsan, Mona Al-Ahmad, Jovan Miljković, Dorothea Terhorst, 2022, original scientific article Abstract: Background: Cold urticaria (ColdU), i.e. the occurrence of wheals or angioedema in response to cold exposure, is classified into typical and atypical forms. The diagnosis of typical ColdU relies on whealing in response to local cold stimulation testing (CST). It can also manifest with cold-induced anaphylaxis (ColdA). We aimed to determine risk factors for ColdA in typical ColdU.
Methods: An international, cross-sectional study COLD-CE was carried out at 32 urticaria centers of reference and excellence (UCAREs). Detailed history was taken and CST with an ice cube and/or TempTest® performed. ColdA was defined as an acute cold-induced involvement of the skin and/or visible mucosal tissue and at least one of: cardiovascular manifestations, difficulty breathing, or gastrointestinal symptoms.
Results: Of 551 ColdU patients, 75% (n=412) had a positive CST and ColdA occurred in 37% (n=151) of the latter. Cold-induced generalized wheals, angioedema, acral swelling, oropharyngeal/laryngeal symptoms, and itch of earlobes were identified as signs/symptoms of severe disease. ColdA was most commonly provoked by complete cold water immersion and ColdA caused by cold air was more common in countries with a warmer climate. Ten percent (n=40) of typical ColdU patients had a concomitant chronic spontaneous urticaria (CSU). They had a lower frequency of ColdA than those without CSU (4% vs 39%, p=0.003). We identified the following risk factors for cardiovascular manifestations: previous systemic reaction to a Hymenoptera sting, angioedema, oropharyngeal/laryngeal symptoms, and itchy earlobes.
Conclusion: ColdA is common in typical ColdU. High-risk patients require education about their condition and how to use an adrenaline autoinjector.
Keywords: adrenaline autoinjector, cold urticaria, COLD-CE, risk factors, systemic reactions, epinephrine, therapeutic use, self administration, injections, intramuscular, methods
Published in DKUM: 06.08.2024; Views: 139; Downloads: 10
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3. Adrenaline autoinjector is underprescribed in typical cold urticaria patientsMojca Bizjak, Mitja Košnik, Dejan Dinevski, Simon Francis Thomsen, Daria Fomina, Elena Borzova, Kanokvalai Kulthanan, Raisa Meshkova, Fernando Monteiro Aarestrup, Dalia Melina Ahsan, Dorothea Terhorst, Marcus Maurer, 2022, other scientific articles Keywords: cold urticaria, systemic reactions, adrenaline autoinjector, cold-induced anaphylaxis
Published in DKUM: 17.08.2023; Views: 348; Downloads: 54
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4. Patch testing with the European baseline series and 10 added allergens : single centre study of 748 patientsKatja Adamič, Nisera Bajrović, Renato Eržen, Maja Jošt, Peter Kopač, Mitja Košnik, Nika Lalek, Mihaela Zidarn, Dejan Dinevski, 2022, original scientific article Abstract: Background: The European baseline series (EBS) of contact allergens is subject to change. An allergen is considered for inclusion when routine patch testing of patients with suspected contact dermatitis results in ≥ 0.5% prevalence rate.
Objectives: We aimed to determine the frequency of sensitizations to 30 EBS allergens and 10 locally added allergens. Additionally, we assessed the strength and evolution of reactions to all tested allergens and co-reactivity of additional allergens.
Methods: Patch testing with our baseline series of 40 allergens was done in 748 consecutive adults. Tests were applied to the upper back and removed by patients after 48 hours. Readings were done on day 3 (D3) and D6 or D7 (D6/7). Positive reactions fulfilled the criteria of at least one plus (+) reaction. Retrospective analysis was done.
Results: Eight allergens not listed in the EBS had ≥ 0.5% prevalence rate (i.e., cocamidopropyl betaine, thiomersal, disperse blue mix 106/124, 2-bromo-2-nitropropane-1,3-diol, diazolidinyl urea, propylene glycol, Compositae mix II, and dexamethasone-21-phosphate), and 16.6% of positive reactions would have been missed without D6/7 readings.
Conclusion: We propose further studies to evaluate whether cocamidopropyl betaine, disperse blue mix 106/124, 2-bromo-2-nitropropane-1,3-diol, diazolidinyl urea, and Compositae mix II need to be added to the EBS.
Keywords: clinical epidemiology, baseline series, contact sensitization, patch tests, simultaneous reactivity
Published in DKUM: 13.07.2023; Views: 320; Downloads: 69
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5. Urtikarija zaradi hlada - dejavniki tveganja za prizadetost dihal ali kardiovaskularnega sistemaMojca Bizjak, 2022, doctoral dissertation Abstract: Urtikarijo zaradi hlada (UH), pri kateri se pojavijo s hladom izzvane urtike, angioedem ali oboje hkrati, delimo na tipično in atipično obliko. Diagnoza tipične UH temelji na pozitivnih lokalnih stimulacijskih testih (LST). Pri UH se lahko razvijejo tudi sistemske reakcije. Namen raziskave je bil določiti dejavnike tveganja za sistemske reakcije pri tipični UH. Mednarodna raziskava imenovana COLD-CE (tj. Urtikarija zaradi hlada in druge s hladom izzvane reakcije – celostno ovrednotenje) je potekala v 32 UCARE centrih (angl. Urticaria Center(s) of Reference and Excellence). Pridobili smo natančne anamnestične podatke in opravili LST s kocko ledu in/ali napravo TempTest®. Prizadetost dihal smo definirali kot dispnejo, piskanje ali stridor. Prizadetost kardiovaskularnega sistema smo definirali kot hipotenzijo ali izgubo zavesti in/ali druge simptome povezane s hipotenzijo (tj. omotica, občutek omedlevice ali nemoči). V raziskavo smo vključili 551 bolnikov z UH in 75 % od njih je imelo pozitivne LST (tj. tipično UH). Pri 40 bolnikih s tipično UH smo diagnosticirali tudi kronično spontano urtikarijo (KSU). Prizadetost dihal je nastopila pri 22 % in prizadetost kardiovaskularnega sistema pri 31 % bolnikov s tipično UH brez KSU. Ugotovili smo tri neodvisne dejavnike tveganja za prizadetost dihal: pričetek UH v otroštvu, orofaringealni in/ali laringealni simptomi ter srbež uhljev. Neodvisni dejavniki tveganja za prizadetost kardiovaskularnega sistema pa so: angioedem, orofaringealni in/ali laringealni simptomi, srbež uhljev ter predhodna sistemska reakcija na pik kožekrilca.
Keywords: COLD-CE, dejavniki tveganja, urtikarija zaradi hlada, sistemske reakcije
Published in DKUM: 29.11.2022; Views: 564; Downloads: 86
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