PECU: A multicenter study on pediatric patients with cold-induced urticaria.
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Karaaslan Betul Gemici, Soyoz Ozgen, Celik Figen Celebi, Akbas Humeyra, Canitez Yakup, Karagol H Ilbilge Ertoy, Aksoydan Beril Canan, Oguzkaya Yagmur Hazal Sadirvan, Uslu Gizem, Erdem Semiha Bahceci, Dikici Ummugulsum, Gungor Hilal, Senol Handan Duman, Anil Hulya, Yasar Adem, Bulbul Lida, Gunaydin Nursen Cigerci, Ucar Ozge Turkyilmaz, Kaya Mehmet Akif, Akarcan Sanem Eren, Arikoglu Tugba, Boyacioglu Ozge Kangalli, Gungor Hatice Eke, Ocalan Merve, Dogru Mahmut, Serbes Mahir, Iskender Nagihan, Kilic Mehmet, Yuksek Mutlu, Yilmaz Ozlem, Tuncel Tuba, Karadag Sefika Ilknur Kokcu, Meric Zeynep, Karakurt Tuba, Aydemir Sezin, Sayili Ugurcan, Ozturk Fadil, Sancakli Ozlem, Bingol Aysen, Celiksoy Mehmet Halil, Nursoy Mustafa Atilla, Ozhan Aylin Kont, Asilsoy Suna, Yilmaz Ozge, Ozcan Dilek, Simsek Isil Eser, Harmanci Koray, Demir Esen, Ozceker Deniz, Ozdemir Oner, Cekıc Sukru, Arga Mustafa, Cavkaytar Ozlem, Ercan Nazli, Bakirtas Arzu, Altinel Zeynep Ulker, Can Demet, Cokugras Haluk, Yucel Esra, Kiykim Ayca
Аннотация
METHODS: This retrospective multicenter study included 203 pediatric patients with ColdU across 30 centers in Türkiye. Clinical characteristics and management of patients were analyzed. Logistic regression was used to identify factors associated with ColdA and disease resolution.
RESULTS: The median age at diagnosis was 14.3 years, and the median age at onset was 10 years; 56.1% of patients were female. ColdA occurred in 17.2%, with increased risk associated with male sex, autoimmune comorbidities, older age, and triggering by cold food/beverage ingestion. Most patients (82.2%) received second-generation H1-antihistamines; omalizumab achieved >90% symptom control in 12 refractory cases. Over a median 3.5-year follow-up, 30.5% achieved disease resolution (median duration: 18 months). The history of anaphylaxis and comorbid atopy significantly reduced the likelihood of remission. Some patients showed adult persistence, without clear predictors.
DISCUSSION: ColdA may occur even without classic high-risk features; pediatric ColdU management should be guided by individualized risk assessment, prioritizing clinical risk factors-such as older age, high-risk cold triggers, angioedema, and autoimmune comorbidities-over isolated diagnostic parameters. In refractory cases, omalizumab is an effective and well-tolerated option. Prior anaphylaxis and comorbid allergic disease predicted poorer remission.