Man almost dies from allergic reaction to cold air
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A Colorado man nearly lost his life when he developed a severe allergy to cold temperatures while entering a chilly bathroom after taking a hot shower.
A case report in the Oct. 27 issue of Emergency Medicine states that the 34-year-old man collapsed on the floor after taking a shower and was later found by his family. He was having difficulty breathing and his skin was covered in hives. What he experienced was a life-threatening systemic allergic reaction (anaphylaxis).
According to the report, when paramedics arrived, the man's family told them that he had a "History of cold air allergies". He had previously developed hives from cold air, but never had a systemic allergic reaction. It was only when he moved from Micronesia to Colorado that he started having these attacks, because Micronesia has a tropical climate whereas Colorado has relatively low temperatures.
EMTs administered epinephrine, put an oxygen mask on the man, and rushed him to the emergency room. By the time he arrived at the hospital, he was sweating profusely and was covered in hives.
Doctors diagnosed him with cold urticaria, an allergic reaction that occurs when the skin is exposed to low temperatures (including cold air and cold water), and patients can also experience symptoms after eating cold drinks.
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The most common symptom is a red, itchy urticaria that develops after exposure to cold temperatures; more severe systemic allergic reactions can occur, causing the allergic person to experience a sudden drop in blood pressure, narrowing of the airway, and difficulty breathing. These more severe allergic reactions usually occur when the entire body is exposed to cold temperatures, as when a person swims in cold water. In this case, the man's skin was exposed to cold air after he had taken a bath.
The doctor confirmed the man's diagnosis with the "Ice test," which meant that an ice cube was to be placed on his skin for about five minutes. If a patient develops a red bulge on the area of skin where the ice cube was placed, it is clear that they have cold urticaria.
The overall prevalence of this allergic condition is still unknown - one European study found it to be 0.05% prevalent. Systemic allergic reactions are also much rarer than these allergic reactions to hives.
In the hospital, the man was treated with antihistamines and steroids, which brought relief to his symptoms. Before he was discharged from the hospital, he was instructed to avoid exposure to cold water or other conditions where his whole body would be exposed to cold temperatures. He was also prescribed an epinephrine auto-injector, which treats systemic allergic reactions in emergency situations.
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