Man Goes Into Anaphylactic Shock From Allergic Reaction To Cold Air

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A man suffered a life-threatening anaphylactic shock after simply stepping out of a shower due to his severe allergy to cold temperatures, according to a new medical case study reported in The Journal of Emergency Medicine.

Shortly after getting out of a hot shower at his home in chilly Colorado, the 34-year-old man was discovered by his family collapsed on the floor and covered in hives. He was promptly rushed to the emergency room where he was found to be in anaphylactic shock, suffering from a rushing heart rate, profuse sweating, and dangerously low blood pressure. The patient eventually recovered after receiving oxygen and adrenaline, also known as epinephrine, along with drugs to suppress the immune system and reduce the allergic reaction. 

Anaphylactic shock refers to a severe allergic reaction in which blood pressure drops so low that the body doesn't receive enough oxygen. This kind of reaction is the result of the body’s immune system overreacting to a trigger, typically something like eating certain foods or an insect sting. However, it appears that this man’s body was, in fact, reacting to cold temperatures.

His family told medical staff at the hospital that he had a history of being ‘‘allergic to the cold weather.’’ The patient had repeatedly suffered from an unusual reaction to the cold after moving to Colorado from Micronesia, a region known for its tropical marine climate. In the past, however, he only expected mild hives after being exposed to the cold, a condition that’s known as cold urticaria.

To confirm the patient was suffering from an extreme case of cold urticaria, his doctors carried out an ‘‘ice cube test,” which simply involves placing an ice cube on the skin for a few minutes. As expected, his skin reacted to the presence of the cold ice. It’s not clear how common cold urticaria is, but it’s thought to occur in around 0.05 percent of people in central Europe. Most people tend to experience relatively mild symptoms, such as a red rash that disappears after a few hours. 

It’s extremely rare to go into anaphylaxis after being exposed to the cold, but it’s not totally unheard of. Another case study from 2019, published in the Italian Journal of Pediatrics, tells the story of a 9-year-old boy who experienced an anaphylactic shock after swimming in the sea. 

Fortunately, there are a few ways to ease the condition. First up, people with the condition are advised to carry an epinephrine pen (sometimes called an epi-pen). This is a medical device commonly used by people with allergies that allows them to self-inject a dose of epinephrine if they come into contact with the allergen in the question. Equally, some patients even benefit from taking antihistamines, the same tablets you take to ward off hayfever symptoms.

Lastly, if possible, avoid sudden exposure to the cold. This isn’t always possible in colder corners of the world, but people can avoid activities such as swimming (or just a piping hot shower on a cold Colorado evening).

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