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cold antibody autoimmune hemolytic anemia
Includes:
1) cold agglutinin syndrome
2) 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 [2]
- prednisone not effective [2]
Specific
cold agglutinin syndrome (primary cold agglutinin disease)
paroxysmal cold hemoglobinuria (PCH)
General
autoimmune hemolytic anemia
References
- Petz LD.
Cold antibody autoimmune hemolytic anemias.
Blood Rev. 2008 Jan;22(1):1-15. Epub 2007 Sep 27.
PMID: 17904258
- Medical Knowledge Self Assessment Program (MKSAP) 18,
American College of Physicians, Philadelphia 2018