Cold urticaria and infectious mononucleosis in children

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Abstract

Physical urticaria includes a heterogeneous group of disorders characterized by the development of urticarial lesions and/or angioedema after exposure to certain physical stimuli. The authors present the case of a child with severe acquired cold urticaria secondary to infectious mononucleosis. Avoidance of exposure to cold was recommended; prophylactic treatment with ketotifen and cetirizine was begun and a self-administered epinephrine kit was prescribed. The results of ice cube test and symptoms significantly improved. Physical urticaria, which involves complex pathogenesis, clinical course and therapy, may be potentially life threatening. Evaluation and diagnosis are especially important in children. To our knowledge this is the first description of persistent severe cold-induced urticaria associated with infectious mononucleosis in a child

Resumen

La urticaria física incluye un grupo heterogéneo de trastornos caracterizados por el desarrollo de lesiones de urticaria y/o de angioedema, después de la exposición a ciertos estímulos físicos. Los autores presentan un caso clínico de un niño con urticaria al frío adquirida grave, secundaria a la mononucleosis infecciosa. Se le recomendó evitar la exposición al frío; comenzó tratamiento profiláctico con ketotifeno y cetirizina y se prescribió kit de epinefrina para auto-administración. La prueba del cubo de hielo y la sintomatologia tuvieron una mejoría significativa. La urticaria física, con etiopatogenia, evolución clínica y terapéutica complejas, puede en ocasiones amenazar la vida del paciente, y al tratarse de niños cobra gran importancia la evaluación y el reconocimiento. De los casos descritos que tenemos conocimiento ésta es la primera descripción de la urticaria frío-inducida grave persistente asociada a mononucleosis infecciosa en niños

References (22)

  • C.J. Tyson et al.

    Cold-induced urticaria in infectious mononucleosis

    Med J Aust

    (1981)
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