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Your Guide to Cold Agglutinin Syndrome

Jul 25, 2019

A person’s immune system is meant to protect them. It stops bacteria and viruses which invade the body. However, in many different diseases and conditions, the immune system is turned against itself. In the case of cold agglutinin syndrome (aka cold agglutinin disease, CAD or antibody hemolytic anemia), the body’s immune system attacks the red blood cells in the bloodstream. The red blood cells are removed quicker than they can be replaced. This leads to a state known as anemia. 

Cold agglutinin is a very unique condition in that it is triggered by the environment around the person. Cold temperatures will cause the body to react and attack the red blood cells. The good news is that this is a fairly rare issue. Only around 1 in about 300,000 people will get cold agglutinin disease. Keep reading to learn more about this fascinating condition. 

Examining Causes

The causes of cold agglutinin syndrome are rather varied. First off, the first type of cold agglutinin syndrome is known as primary cases. These cases have no cause. It can affect anyone! That being said, people over the age of 60 and women are more likely to get cold agglutinin syndrome. 

The second scenario is when cold agglutinin syndrome occurs due to the body also having another disease. The most commonly linked disease is lymphoma. This lymph node affecting cancer isn’t the only one however, with other blood based cancers like leukemia also sometimes causing CAD. Whether it’s a virus, bacteria or parasite, cold agglutinin syndrome is possible. 

Symptoms and Diagnosis

There are many symptoms which people may suffer from. Women often find their periods are inactive for the period they have cold agglutinin disease. In some cases, some people get Raynaud’s phenomenon. It’s a numb feeling in the fingers and toes which also has a loss of color. Symptoms are worse in cold weather, so winter has the most incidents reports. Symptoms also include: Pale or yellowing of the skin, feeling cold in the hands and feet, a predisposition to headaches and dizziness, soreness in the legs, joints and back, irritable behavior, vomiting, diarrhea. 

To diagnose cold agglutinin syndrome, a doctor will take a blood test. The red blood cell count in this test can help quickly diagnose the issue. Diagnosis is performed if there’s not enough red blood cells, or the blood is made up of too many newly created red blood cell count. From there, a second test will be performed to check on the cold agglutinin within the body. 

Treatment Plans

For very mild cases of cold agglutinin syndrome, treatment will consist of a single step: Stay out of cold weather and stay warm. This is because minor cases will often clear up on their own. Treatment for more severe cases are a bit different. Moderate cases can receive blood transfusions. This is due to red blood cell counts being very low without a reasonable expectation of recovery. A doctor can also perform plasmapheresis. This is a treatment in which the blood is filtered to get rid of the antibodies that are causing the cold agglutinin syndrome. 

In cases of secondary cold agglutinin syndrome, treatment is different. Treatment has to be aimed at the disease or illness which is causing the CAD in the first place. This can vary as there are an incredible number of issues which can cause CAD as a secondary condition. 

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