Cold agglutinin disease (CAD)

A subtype of anemia in which abnormal bone marrow cells (called cold agglutinins) activate an immune system mechanism called the complement pathway, resulting in the destruction of red blood cells as they are attacked by antibodies. There are two forms of the condition: primary, when the cause is unknown, and secondary when there is a known disease or illness associated with the condition’s onset.

Fatigue, weakness, pallor, dizziness, palpitations, shortness of breath, darker urine, sweating, coldness of the fingers and/or toes, swollen lymph nodes, and painful bluish/reddish discoloration of the skin (fingers, ankles, wrists).

Jaundice, dyspnea (difficult or labored breathing), acrocyanosis (bluish discoloration of the extremities), Raynaud’s, hemolysis, mycoplasma infection, mumps, cytomegalovirus, non-Hodgkin’s lymphoma, chronic lymphocytic leukemia, monoclonal gammopathy of unknown significance, infectious mononucleosis (Epstein Barr Virus), systemic lupus erythematosus, rheumatoid arthritis, and heart arrhythmias.

The age group most commonly affected by CAD is between 41 and 83. Having certain infectious diseases, immunoproliferative diseases, or connective tissue diseases is a risk factor.

Females experience CAD twice as often as males do and those who live in colder climates tend to be diagnosed with it more often.

• Long-term sutimlimab improves quality of life for patients with cold agglutinin disease: CARDINAL 2-year follow-up (2023)
• The Histopathology of Cold Agglutinin Disease-Associated B-Cell Lymphoproliferative Disease (2023)
• Medically-attended anxiety and depression is increased among newly diagnosed patients with cold agglutinin disease: Analysis of an integrated claim-clinical cohort in the United States (2022)
• Monoclonal antibodies for treatment of cold agglutinin disease (2023)
• Mortality in cold agglutinin disease shows seasonal pattern (2022)
• Cold Agglutinin Disease–Associated Transient Ischemic Attack, Non-ST Elevation Myocardial Infarction, and Skin Necrosis: A Case Report (2023)