Chronic Cold Agglutinin Disease: A Case Report with Review of Literature

Chronic cold agglutinin disease (CAD) is a sub-group of autoimmune haemolytic anaemia (AIHA). Cold reactive immunoglobulins (cold agglutinins) which are directed against erythrocyte surface antigens ('I'antigen) are essential for the pathogenesis of CAD. Classically, the patients with CAD present with chronic anaemia and acrocyanosis. Several factors like the antibody titre and the temperature range determine the ability of cold agglu-tinins to induce haemolysis. The specific problems that occur in the laboratory due to pathologic cold agglutinins need to be kept in mind for the accurate diagnosis and treatment of the patient. Novel immuno-suppressive therapies are being tried, both to reduce cold agglutinin production as well as to cure CAD. Here, we are reporting a case with repeated episodes of haemolysis due to cold agglutinins in a middle aged man.