The increased secretion of TRPM8+mitochondria+EVs detected in monocytes with ZNF334 truncation mutation might also exert intercellular proinflammatory signals, further amplifying systemic autoinflammation, chemotaxis of activated monocytes and lymphocytes to cold-stimulated perivascular areas, and contributing to the cold-induced fever, urticaria-like skin rashes, and excessive vasospastic symptoms seen in our patient. The gene discussed is TRPM8; the disease is urticaria.