Article

Cold agglutinin induced hemolysis in a newly diagnosed systemic lupus erythematosus.

Oklahoma University of Health Sciences Center, Oklahoma City, Oklahoma 73104, USA.
The American Journal of the Medical Sciences (Impact Factor: 1.33). 03/2010; 339(3):270-3. DOI:10.1097/MAJ.0b013e3181ac3bd5
Source: PubMed

ABSTRACT Systemic lupus erythematosus (SLE) is a well-known autoimmune chronic inflammatory disease, which can virtually affect any organ system in the body. Although hemolytic anemia has been known to occur in <10% of SLE patients, they are usually mediated through warm antibodies. It is extremely rare to see cold antibody-mediated hemolytic anemia in SLE, and only few cases have been reported in literature to our knowledge. This is a unique case report of SLE associated with cold agglutinin hemolytic anemia in a patient presented with generalized tender lymphadenopathy and typical B-symptoms including fever, night sweats, and significant weight loss.

0 0
 · 
0 Bookmarks
 · 
104 Views
  • Source
    [show abstract] [hide abstract]
    ABSTRACT: Exact diagnosis of the subtype has essential therapeutic consequences in autoimmune hemolytic anemia. Cold-antibody types include primary chronic cold agglutinin disease (CAD) and rare cases of cold agglutinin syndrome (CAS) secondary to cancer or acute infection. Primary CAD is a clonal lymphoproliferative disorder. Not all patients require pharmacological therapy, but treatment seems indicated more often than previously thought. Corticosteroids should not be used to treat primary CAD. Half of the patients respond to rituximab monotherapy; median response duration is 11 months. The most efficient treatment to date is fludarabine and rituximab in combination, resulting in responses in 75%, complete responses in 20% and median response duration of more than 66 months. Toxicity may be a concern, and an individualized approach is discussed. Erythrocyte transfusions can be given provided specific precautions are undertaken. No evidence-based therapy exists in secondary CAS, but optimal treatment of the underlying disorder is essential when feasible.
    Blood reviews 02/2012; 26(3):107-15. · 7.19 Impact Factor

Nandakumar Srinivasan