While food allergies are common, allergic reactions and anaphylaxis can also be triggered by non-food allergens including animals, medication, cosmetics, and even cold temperatures.
Sara Morgan shares her experience of her son Quinn’s cold urticaria diagnosis.
By Sara Morgan, Quinn’s mother
If you were going to discover your child had an allergy to cold, you would expect it to happen in the depths of the winter months, wouldn’t you? Not, as we did in Quinn’s case, at the height of British summertime.
It was the school summer holidays and the weather was glorious. We packed up the car and off we went to one of the local splash pads for the day. I lathered both kids in sun cream and then sat back down to watch them play.
Within approximately ten minutes, Quinn was back, claiming he was itching all over. He was covered from head to toe in white bumps and his skin was bright red. I had recently bought new sun cream and I immediately thought that this was the culprit. I wrapped him up in a towel and he never asked to go back in the water.
Not long after, we visited another splash pad and the same happened again, only this time the weather wasn’t as warm and his reaction was much worse. He was bright red, covered in hives, in pain and claiming his vision was going black. Was it still the sun cream or was there something in the treated water that he was reacting to? I never considered for a second that it was the temperature of the water.
After that reaction, we took him along to the GP who wasn’t overly concerned. We were given antihistamines and told to give him a dose before exposure to the water. The GP didn’t think it was worth a referral to a consultant, but wrote us an open referral for my private healthcare plan via work (who subsequently refused the claim). I left reassured that it wasn’t anything sinister.
We decided to visit the local paddling pool and, as instructed, I gave Quinn his antihistamines before we left. He plunged his whole body into the water and the nightmare began. On top of the usual bright red skin and hives, he was writhing around on the ground crying out in pain and saying he couldn’t see. When he tried to stand up, he would collapse again, like he was fainting. His little brother was in the pool by himself, and I was on my own on the side with a child who I didn’t realise was in anaphylactic shock. I wrapped him up, cuddled him in and eventually he started to return to normal. Knowing what I know now, I should have dialled 999, but I had no idea that’s what anaphylaxis looked like. I always thought it was where your lips swelled up and you struggled to breathe because you were allergic to a certain type of food. I had never thought that it looked like fainting. I carried him back to the car while his two-year-old brother walked alongside me. He was completely wiped out for the rest of the day.
Back to the GP and a referral was made to the allergy team at the children’s unit of our local hospital. We also booked and paid for a private consultant appointment in the meantime.
The private consultant diagnosed Quinn with cold urticaria, prescribed antihistamines and an adrenaline auto-injector (AAI), and gave us lots of useful advice on management of the condition. Cold urticaria is a skin reaction to cold stimulus. The reaction can be minor (hives) or severe (anaphylaxis), with the worst reactions occurring on whole body exposure, for example, cold water swimming. He told me that avoidance of cold stimulus and antihistamines was the only way to manage his condition.
Cold-induced urticaria is a rare condition. People who experience cold urticaria will develop hives when their skin is chilled by cold water, cold rain or cold weather. If you believe you may have cold urticaria you may be at risk of cold anaphylaxis, so it is important to speak with your GP and ask to be referred to an NHS allergy clinic.
His NHS appointment came through a few months later and he went to visit the local allergy team. His condition is so rare, staff came into the room to see his reaction to the ice cube test (the common method for diagnosing cold urticaria). He was given blood tests to rule out anything underlying, which came back negative.
Thankfully for Quinn, he is able to lead a relatively normal life with the help of his antihistamines. His cheeks still go bright red in the winter cold and he can get itchy and uncomfortable but, so long as he is appropriately wrapped up, he can enjoy the outdoors like any other child. He continues to swim three to four times a week for our local swimming club without any issues. I do, however, know the temperature of every single swimming pool in the north-east of England and I’m always sat poolside with his AAI, just in case.
I would love to see more information, awareness and support groups out there for this condition. I was completely dismayed by the lack of resource and knowledge when Quinn was diagnosed. I’m hoping that, by writing his story, this will help any parents going through something similar.
Anaphylaxis is a potentially life-threatening condition which requires an immediate emergency response. Signs of anaphylaxis are often referred to as the ABC symptoms: