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- Cold agglutinin disease is a type
of hemolytic anemia, which is a disease characterized by
decreased red blood cells (the oxygen carrying cells) due to
their destruction.
- It is caused by the body mistakenly
making antibodies (of the IgM type) against a component (the
I antigen) of red blood cells. The unusual feature of this
disease is that at normal body temperature (98.6F) the
hemolysis does not occur, but rather, only at lower
temperatures. Therefore, peripheral areas of the body that
are cooler, such as the fingertips, nose, and ears, are most
likely to be affected. Most cases of cold agglutinin disease
are mild, though rarely it may cause a severe hemolytic
anemia.
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- Mottled or numb fingers or toes on
exposure to cold
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- Complete blood count shows mild anemia, reticulocytosis, and
spherocytes
- Direct Coombs test will be positive for complement
only
- Bedside cold agglutinin
test
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- Avoid exposure to cold
- Severe cases may require
Chlorambucil or similar medication
- High dose intravenous immunoglobulin or interferon may help some severe cases.
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