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August 20, 1982

Infectious Mononucleosis and Cold Urticaria

JAMA. 1982;248(7):828. doi:10.1001/jama.1982.03330070016008

To the Editor.—  The recent article by Lemanske and Bush (1982;247:1604) reported a case of cold urticaria associated with infectious mononucleosis. We would like to support their findings by presenting a similar case.

Report of a Case.—  A 26-year-old man had a week-long history of pruritus, erythema, and urticaria that first appeared after ingesting cold foods and then progressed to occurring after exposure to cold air or after contact with cold surfaces. No respiratory distress was noted. He had a nonproductive cough with myalgias in the week preceding the onset of urticaria. There was no personal or family history of allergies or urticaria. Physical examination disclosed urticaria on forearms, buttocks, and calves. Submaxillary, axillary, and anterior cervical adenopathy were present, but without hepatosplenomegaly. The presence of urticaria was confirmed by a positive response to an ice cube test. Other laboratory data were as follows: WBC count, 10,000/cu mm, with 79%