Cold urticaria was found to be the solitary symptom in a patient with chronic lymphocytic leukemia and an associated cryoglobulinemia. Following therapy there was a concurrent remission in both the cold urticaria and cryoglobulinemia. It was then possible to produce local sensitization to cold in the patient's skin by injecting serum collected during the pretreatment phase. The injection of posttreatment serum was without effect. Cold urticaria could be induced not only by injection of the cryoprecipitate, an IgG immunoglobulin, in concentrations as low as 25 mg/100 ml but also by the supernate after removal of the cryoglobulin. Addition of streptomycin to the serum prevented both cryoprecipitation in vitro and cold sensitization in vivo. Attempts to demonstrate an immunological mechanism for the production of cold urticaria were unsuccessful.
Rawnsley HM, Shelley WB. Cold Urticaria With CryoglobulinemiaIn a Patient With Chronic Lymphocytic Leukemia. Arch Dermatol. 1968;98(1):12-17. doi:10.1001/archderm.1968.01610130018003