What is Cold Agglutinin Disease?

Cold weather can be frustrating if you have a rare blood disorder called cold agglutinin disease. Cold agglutinin is a form of the disease called autoimmune hemolytic anemia that usually occurs when the temperature of your blood drops below normal body temperature.

1. What is the mechanism leading to cold agglutinin?

In cold agglutinin disease, the antibodies attack healthy red blood cells when exposed to cold temperatures, about below 50 degrees. Blood in your fingers, toes, nose, and ears can quickly drop below normal body temperature.
Cold agglutinins attach themselves to red blood cells and pull them together, attracting other proteins (antibodies) in your immune system to break down cell walls and destroy cells. The red blood cells are then destroyed. Then your body may not be able to make enough new red blood cells to replace the damaged ones, resulting in anemia. In this case your blood is not enough to carry oxygen to your vital organs to function as they should.

vỡ hồng cầu — Các agglutinin lạnh làm phá hủy hồng cầu gây ra tình trạng thiếu máu

2. What is the cause of cold agglutinin disease?

Cold agglutinin disease can be primary or secondary.
2.1 Primary This disease may be self-occurring, unrelated to another disease. It's like a number of other autoimmune diseases for which scientists don't know the exact cause. It usually affects people over the age of 60 and seems to occur more in women than men.
2.2 Secondary Secondary cold agglutinin disease is caused by another medical condition and can appear in people of any age. It is commonly associated with three diseases:
Infections, most commonly pneumonia (mycoplasma) and mononucleosis (Epstein-Barr virus).
Certain diseases are caused by viruses (mumps, rubella, chickenpox, cytomegalovirus, influenza, and HIV) or bacteria (Legionnaire's disease, syphilis, listeriosis, and E. coli; and some parasitic infections, including including malaria).
Blood cancers, including lymphoma, chronic lymphocytic leukemia and myeloma.

Ung thư máu là một trong những bệnh làm tăng nguy cơ bị agglutinin lạnh

3. Symptoms

Cold agglutinin disease can make you feel weak and tired and is often worse in winter. Other signs of it include:
Dizziness and headache Back, leg or joint pain Hearing ringing in the ears Discomfort or behavior change Pale or yellow skin Vomiting or diarrhea Cold feet or hands Chest pain or irregular heartbeat In women, cold agglutinin sometimes stops them from getting their period. Some people with cold agglutinin may also experience colds, numbness, and discoloration in their fingers or toes, known as Raynaud's phenomenon.

4. Treatment

Treatment depends on the severity of your symptoms and whether your cold agglutinin disease is secondary.
If you have another condition that leads to cold agglutinin disease, your doctor will try to treat that first and see if it helps in reducing the symptoms of cold agglutinin disease. For example, if it's caused by bacteria or a virus, your symptoms may go away a few months after you clear the infection. If your symptoms are mild, you may not need treatment. You can avoid problems by staying warm and staying out of cold weather.

Giữ ấm cơ thể — Người bệnh chỉ cần giữ ấm cho cơ thể nếu triệu chứng agglutinin nhẹ

If your red blood cell count is very low, your doctor may need dialysis to remove antibodies or you will receive a blood transfusion. These are short-term treatments that may give you temporary pain relief, but don't change the cause of the problem. If anemia is severe, you may need medication. The most commonly used drug is rituximab, a drug that targets certain immune cells. (It was originally created to treat lymphoma) Rituximab works well in more than half of the people who take it. Also your doctor may recommend another medicine in combination with it. But combinations of drugs can sometimes have serious side effects. If all of the above treatments don't work, your doctor may prescribe a medicine called bortezomib that is made to treat a type of cancer called multiple myeloma.

5. Take good care of yourself when you have cold agglutinin

You should familiarize yourself with cold agglutinin by keeping warm first. You should dress warmly in winter and sometimes even in summer, as air conditioning can also cause your body to react. You should stay away from cold foods and cold drinks. Cold agglutinin disease is a rare condition, but if you have it, you're not alone. Support organizations and online community groups can help you learn more and connect with others going through similar situations.
If there is a need for consultation and examination at the Hospitals of the National Health System, please book an appointment on the website for the best service.
Reference article source: webmd.com

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