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Getting the latest healthcare news for you
Getting the latest healthcare news for you
The standard cold stimulation test (SCST) used to diagnose cold urticaria (ColdU) misses about a third of patients who have real, convincing symptoms. A multinational study of 364 patients found that SCST-negative patients tend to be younger with a stronger family history, while SCST-positive patients face more severe symptoms like breathing difficulties and cardiovascular issues. Experts say a negative test result should never rule out the condition.
The go-to diagnostic test for cold urticaria (ColdU) — the standard cold stimulation test (SCST) — is leaving a significant number of patients undiagnosed. A new multinational observational study found that roughly 1 in 3 patients with convincing cold-induced symptoms tested negative on the SCST, revealing a clinically distinct subgroup that has long been poorly understood.
The study analyzed 364 ColdU patients across 11 urticaria centers in nine countries. SCST-negative patients tended to be younger, had earlier disease onset, were more likely to have a family history of ColdU, and responded better to standard-dose antihistamines. Meanwhile, SCST-positive patients carried a heavier clinical burden — with higher rates of angioedema, breathing difficulties, and cardiovascular symptoms — and were more frequently prescribed adrenaline autoinjectors.
Key Takeaways:
Why it matters: Misdiagnosis or delayed diagnosis of ColdU can leave patients vulnerable to potentially life-threatening reactions. This study highlights a critical gap in current diagnostic practice and calls for a more comprehensive, symptom-driven approach beyond a single negative test result.
