Iatreia (Apr 2020)
First case series reported in Colombia of primary and secondary cold agglutinin disease. Experience of a reference center in Medellín between 2010 and 2017
Abstract
Introduction: Cold agglutinin disease (CAD) is a primary hematologic disorder or can be secondary to another disease. CAD is characterized by autoim-mune hemolytic anemia associated with IgM type antibodies, at low temperatures. Clinically CAD is associated with cryoparesthesia and acrocyanosis induced by cold and fever, or it can be asymptomatic and can be detected by abnormalities on cell blood counts. Objective: To describe the clinical and laboratory data and the etiology of CAD. Comparison between this case series and those described in the literature. Materials and Methods: Retrospectively, we analy-zed clinical data of patients from Hospital Universi-tario San Vicente Fundación with positive results for cold agglutinin assays made in the hematology lab from Universidad de Antioquia. We consider patients with titers ≥ 1:64 or Coombs test positive for cold an-tibodies. Results: We describe clinical and laboratory findings included crioagglutinin titers of 23 cases with CAD: 6 of them with primary CAD, 4 with non-Hodgkin Lym-phoma (NHL), 8 patients with CAD associated with infectious and autoimmune disease and 5 with CAD miscellaneous diseases. Disscusion and Conclusions: This is the first CAD case series described in Colombia. Age and gender were like others case series. Most of patients presented with hemolityc anemia and cold related symptoms. The hemoglobin/ hematocrit ratio was 1:2. Secondary causes were vasculitis, lupus and malaria. Primary CAD were related to NHL, specifically limphoplasmo-cytic Most of the treatments of primary CAD included rituximab.
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