Coomb's negative cold agglutinin disease

Abstract

Cold agglutinin disease (CAD) is a rare type of autoimmune hemolytic anemia which usually results due to production of immunoglobulin M-type autoantibody against the I/i and H antigens on red blood cell membrane. They can be idiopathic or may be due to underlying lymphoproliferative disorders or atypical infections. It can have a varied presentation ranging from being incidentally detected to being totally transfusion dependent for a longer or shorter duration. Several factors play a role in determining the ability of cold agglutinins in inducing hemolysis such as antibody concentration and temperature. Here, we present a 54-year-old patient, a known case of chronic obstructive pulmonary disease who was admitted to our hospital in the winter months as a case of alcohol withdrawal syndrome. During the course of the stay, the patient developed respiratory insufficiency and went into Type II respiratory failure and hematological investigations revealed features of CAD.

IgA plasma cell myeloma presenting as cold agglutinin-induced haemolytic transfusion reaction

“…Cold agglutinin disease (CAD) is a rare type of primary autoimmune haemolytic anaemia, caused by immunoglobulins (usually IgM but also IgG or IgA) that react with erythrocytic surface antigens (most commonly I/i or H proteins) as the temperature approaches 0°C 1…”