Autoimmune Hemolytic Anemia with Complete Cold Agglutinins

What is Autoimmune Hemolytic Anemia with complete cold agglutinins?

The disease is characterized by a gradual increase in symptoms, while the main complaints that patients present are complaints of a general nature: decreased performance, weakness, indisposition, cold intolerance. Most of the patients after exposure to cold note the blue and then the whitening of the fingers, toes, as well as the ears, the tip of the nose. There is a sharp pain in the limbs. After a long stay in the cold, such patients often develop gangrene of the fingers.

In some patients after cooling, urticaria appears. In some cases, the liver and spleen are enlarged.

Symptoms of Autoimmune Hemolytic Anemia with complete cold agglutinins

The course of the disease is usually chronic. Clinical manifestations are more pronounced in winter and sometimes almost completely absent in summer. Most patients do not have crises. Recovery from idiopathic form practically does not occur. It is extremely rare disease ends in death. Sometimes a cold form of immune hemolytic anemia is observed as an episode in the event of a viral infection (flu, infectious mononucleosis) or immediately after a decrease in temperature during such an infection. In these cases, there may also appear clinical signs of the disease (Raynaud’s syndrome, an enlarged spleen, a decrease in hemoglobin, a sharp increase in ESR, the inability to determine the blood group), but all these phenomena disappear completely in 1-2 months.

Diagnosis of Autoimmune Hemolytic Anemia with complete cold agglutinins

The hemoglobin level in most patients ranges from 80 to 100 g/l. The content of leukocytes and platelets is usually not reduced.

The cold form of autoimmune hemolytic anemia is characterized by autoagglutination of red blood cells, which manifests itself immediately, during blood drawing, and often interferes with the determination of the number of red blood cells, ESR. Often there is an autoagglutination in a smear. This agglutination is reversible and completely disappears when reheated. Bilirubin content is normal or slightly increased. In the study of the protein fractions of blood in a number of patients a separate fraction of the protein is found, which is a cold antibody. Some patients find protein in the urine (free hemoglobin). However, hemoglobinuria cannot be considered a frequent symptom of the disease.

The combination of moderate anemia with signs of increased erythrocyte destruction, a sharp acceleration of ESR, Raynaud’s syndrome, changes in protein fractions of blood, the inability to determine blood type and red blood cell count make you suspect cold hemagglutinin disease and examine complete cold agglutinins.