There are two forms of this type of urticaria hereditary and idiopathically acquired primary. The first is fairly rare ad it is more common to acquire it but often the origin remains unclear. Sometimes it is a secondary to some diseases (e.g. lymphocytic leukaemia, lymphosarcoma, hepatitis, infectious mononucleosis).
The wheals that appear are in response to being exposed to a cold condition, e.g. water, air or a cold object. For some reason unknown this activates the mast cells and subsequent release of inflammatory mediators.
The most common cause is swimming in cold water and the reaction can be quite severe. We are able to help treat this condition. It initiates within 2 -5 minutes of change of temperature and can last several hours.
The hereditary form takes longer to show up after exposure, anything from eight to forty eight hours and can last up to two days.
The wheals can deepen with more severe swelling denoting angioedema is occurring and become itchy in localised spots or the body in general.
When urticaria and angioedema evolve systemic symptoms can become apparent. These symptoms can include degrees of dyspnoea (breathing difficulties), wheezing and coughing, abdominal pain like cramping and tachycardia(When the heart rate increases to greater than 100 beats per minute) usually indicative of some sort of shock as it increases the blood supply to the periphery of the body.
Quite often at this stage hypotension (drop in blood pressure) also occurs. This requires immediate medical intervention as it can become life threatening. If this happens in the water while the person swimming, a severe reaction could cause drowning. If a person knows that they have the condition they should take all precautions not to swim alone or to inform others that they are with of the potential response to their condition.
The acquired form usually affects young adults in the 18 - 25 years range and can last five or six years.
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