Evidence map›Paper›PMID 42368988›Full record

ArticleMediterranean journal of rheumatology2026

Post-EBV Cold Urticaria with High-Titre Cold Agglutinins without Haemolysis: A Paediatric Case Report.

Zoe Bezirgiannidou, Iliana Stamatiou, Christina Spanopoulou, Antigoni Mavroudi, Nikolaos Kitsos, Emmanouil Spanoudakis, Ioannis Kotsianidis, Dimitrios Cassimos

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In one paragraph

Article in Mediterranean journal of rheumatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Zoe BezirgiannidouDepartment of Haematology, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece.
Iliana StamatiouDepartment of Haematology, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece.
Christina SpanopoulouDepartment of Rheumatology, KAT General Hospital of Athens, Athens, Greece.
Antigoni MavroudiFaculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Nikolaos KitsosDepartment of Paediatrics, Faculty of Medicine, University of Thessaly, Larissa, Greece.
Emmanouil SpanoudakisDepartment of Haematology, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece.
Ioannis KotsianidisDepartment of Haematology, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece.
Dimitrios CassimosPaediatric Department, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This report describes a paediatric case of cold urticaria (ColdU) associated with markedly elevated cold agglutinin titres following Epstein-Barr virus (EBV) infection. An 11-year-old girl developed recurrent cold-induced urticaria and anaphylaxis after a recent EBV infection. Immunohaematologic testing revealed a cold-reactive IgM autoantibody with anti-i specificity. Despite the exceptionally high peak titres (>1:262,144 at 4°C), and the unusually broad thermal amplitude extending to 30°C, no clinical or laboratory evidence of haemolysis was observed, and the direct antiglobulin test remained persistently negative. Complement components and cryoprotein assays were consistently normal. Throughout an extended 52-month longitudinal follow-up, antibody titres gradually declined in parallel with the resolution of urticarial symptoms and withdrawal of antihistamines. This case demonstrates a non-haemolytic, post-infectious immune phenotype of ColdU, in which transient, high-titre cold agglutinins coexist with cutaneous hypersensitivity without haemolytic manifestations, and highlights the importance of comprehensive immunohaematologic evaluation and long-term monitoring in ColdU cases with atypical serologic findings.

Indexed as

cold agglutininscold urticariaEpstein–Barr virusimmune responsepaediatrics

Identifiers

PMID42368988
PMCPMC13305941

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