This is a 3-year-old 8-month-old female patient who was referred for consultation due to urticaria and angioedema upon contact with cold water.
On one occasion, while she was in a piscin, she presented an episode of generalized hypotonia, dryness and loss of consciousness that required hospitalization.
Erythema and swelling in the neck were present with cold drinks.
The ice cube test was performed, which was positive at six minutes.
Treatment with cyproheptadine was started, with improvement of symptoms.
One month after the beginning of treatment, a new ice cube test was performed, which was negative at 10 minutes.
The patient received ciproheptadine for six months, reaching the top dose for her weight, but due to persistent symptoms associated with cold contact, it was decided to change the treatment with cetirizine plus montelukast
The patient has been followed for four years and currently still presents urticaria associated with bathing and piscins, but without respiratory involvement and spontaneous resolution.
