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Case Report


Cold Urticaria and Celiac Disease


M Pedrosa Delgado,1 F Martín Muñoz,1 I Polanco Allué,2 M Martín Esteban1

1 Allergy Department, University Hospital La Paz, Madrid, Spain
2 Pediatric Gastroenterology and Nutrition Department, University Hospital La Paz, Madrid, Spain

J Investig Allergol Clin Immunol 2008; Vol. 18(2): 123-125



Cold urticaria can be associated with blood and thyroid disorders, drugs, or infections. Celiac disease is an autoimmune enteropathy caused by permanent gluten intolerance. It is often associated with other autoimmune diseases, such as chronic idiopathic urticaria. Nevertheless, association with cold urticaria has not yet been described. A boy aged 3 years 8 months presented local urticaria-angioedema when exposed to cold temperatures. An ice cube test was positive and iron defi ciency anemia was demonstrated. He later developed legume intolerance, rhinoconjunctivitis related to pollen sensitization, and asthma. Due to persistence of cold urticaria symptoms and refractory anemia, a test for immunoglobulin A autoantibodies to tissue transglutaminase and an intestinal biopsy were performed. Results of both tests were compatible with celiac disease. A study of human leukocyte antigen indicated a high risk phenotype (HLA, DR6/DR7; DQA 0501, 0201; DQB 0301, 0201). After 7 months of a gluten-free diet, the boy’s anemia resolved and he is free of symptoms when exposed to cold. This is a fi rst description of the possibility of an association between celiac disease and cold urticaria. A poor course of cold urticaria in the absence of evidence of another underlying condition should lead to suspicion of celiac disease.

Key words: Urticaria. Physical urticaria. Celiac disease. Antigliadin. Gluten.