cold urticaria

I am a 24 yr old female who lives in Australia... I was diagnosed with cold urticaria at age 14, after I went swimming in a cold pool, I fainted when I got out of the pool and nearly went into anaphalctic shock... I have had to carry an epi-pen with me everywhere for the past 10 years... I never take any medications such as antihistimines...I just avoid cold triggers, never go swimming, never go to the snow... only limit myself to how much of an ice-cream i can eat, before my tongue and lips start to swell up and hurt.... I have read many forums regarding cold urticaria, and many people and drs have said that it usually onlys lasts for 5-6 years..... I have had it for 10 years now, ans have learnt to live with it... My only concern is that I have a 6yr old son and a 2 yr old daughter, and I worry that they may develop cold urticaria later in life from me? Is is possible to carry it onto your children? Any info from anyone would be great! :) Bek

[National Jewish Health]

The following citation is for an article from Allergie-Centrum-Charite, Department of Dermatology and Allergy, Charite- Universitatsmedizin Berlin, Berlin, Germany.  Cold Urticaria Symptoms can be Safely Prevented by Ebastine by M. Magerl, J. Schmolke, F. Siebenhaar, T. Zuberbier, M. Metz, M. Maurer in Allergy, December 2007, Volume 62, Number 12, pages 1465-1468.

Ebastine is a non-sedating antihistamine that has been reported to provide symptomatic treatment of idiopathic chronic urticaria and seasonal and perennial allergic rhinitis.  Although it is currently unavailable in the United States, this may be of interest to you and your doctor.

The citation below is for an article from the Division of Dermatology and Department of Medicine, Dalhousie University, Halifax, NS, Canada, ***@****.  Use of Kineret® (anakinra) in the Treatment of Familial Cold Autoinflammatory Syndrome with a 16-Month Follow-Up by Barrie J Ross, Laura A Finlayson, Jennifer P Klotz, Richard Langley, Roxanne G Gaudet, Kara Thompson, Sarah M Churchman, Michael F McDermott, Philip N Hawkins in Journal of Cutaneous Medicine and Surgery, January-February 2008, Volume 12, Number 1, pages 8-16.

Unfortunately, there is a familial type of cold urticaria.

Cold urticaria has been reported in association with a variety of diseases characterized by abnormal immunoglobulins that have some cold-dependent property.  Thus, it may be seen in cryoglobulinemia, cold agglutinin disease, cryofibrinogenemia, and paroxysmal cold hemoglobinuria.

Although this disease generally responds to antihistamines, cyproheptadine appears to be particularly effective.  In my experience, 8 to 16 mg of cyproheptadine daily in divided doses renders the ice cube test negative in most patients and affords considerable objective relief of symptoms when they are exposed to cold.  Cyproheptadine does not inhibit histamine release and appears to act as a classic histamine1 (H1) receptor antagonist.  Therefore, any antihistamine given in sufficient dosage may be effective.  Nevertheless, cyproheptadine remains the drug of choice.

For further assistance, you may wish to seek consultation at National Jewish Health in Denver, Colorado, where several allergy specialists have a special interest in urticaria.