cold antibody autoimmune hemolytic anemia

Introduction

Includes:

• cold agglutinin syndrome
• paroxysmal cold hemoglobinuria

Etiology

• lymphoproliferative disorders
  • Waldenstrom's macroglobulinemia
  • B-cell non-Hodgkin's lymphoma
  • IgM MGUS
• infection
  • Mycoplasma
  • Epstein-Barr virus
• idiopathic

Laboratory

• positive direct antiglobulin showing C3 on erythrocytes
• agglutinated erythrocytes on peripheral smear
• complete blood count (CBC)
  • anemia
  • reticulocytosis
  • improbably high MCV due to agglutinated RBC

Management

• keep patient warm
  • all infusions at body temperature
• rituximab
• prednisone not effective

More general terms

• autoimmune hemolytic anemia

More specific terms

• cold agglutinin syndrome (primary cold agglutinin disease)
• paroxysmal cold hemoglobinuria (PCH)