Cold-Induced Anaphylaxis (ColdA)
ColdA (defined as involvement of at least two different organs or
systems or hypotension11 in response to a cold
trigger) was recorded in 17.3% of patients. Symptoms of coldA were
predominantly shortness of breath (44.4%) and hypotension/syncope
(44.4%), and less commonly abdominal pain (22.2%), headache (22.2%),
and fatigue (11.1%). Triggers of coldA were swimming (44.4%) or cold
air (44.4%) and one child (11.1%) reported a history of coldA episodes
triggered by both swimming and cold air. One patient (11.1%) required
treatment with an epinephrine autoinjector and no fatalities or
hospitalizations from coldA were recorded. Elevated eosinophils were
associated with a history of coldA (aOR=1.38 [95%CI: 1.04, 1.83],
Table 3), when controlling for sex and age.