Cold agglutinin related acrocyanosis and paroxysmal haemolysis.
The clinical features of severe cold agglutinin related paroxysmal agglutination and haemolysis could be confused with a number of conditions. A 61-year old lady presented with features of acute peripheral ischaemia who had recently been started on treatment for Raynaud's disease. Haematological investigations revealed the presence of potent cold haemagglutinins to be the cause of her symptoms but no definite cause for the raised titres were found. She was managed conservatively by keeping her hands and feet warm and regular chlorambucil for a suspected underlying lymphoproliferative disorder. It is important to differentiate the features of Raynaud's disease from those of severe haemagglutination so that identification of any underlying disorder can be made and appropriate treatment instituted.
Sinha
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A
Russells Hall Hospital, Dudley Group of Hospitals NHS Trust, Dudley, West Midlands DY1 2HQ, UK. kushyash@hotmail.com
Richardson
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G
Patel
R T
RT
D000744:Anemia, Hemolytic, Autoimmune / Q000175:diagnosis* / Q000628:therapy; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D002699:Chlorambucil / Q000627:therapeutic use; D003490:Cyanosis / Q000209:etiology* / Q000628:therapy; D003937:Diagnosis, Differential; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006457:Hemoglobinuria, Paroxysmal / Q000175:diagnosis* / Q000628:therapy; D006358:Hot Temperature / Q000627:therapeutic use; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D007145:Immunoglobulin kappa-Chains / Q000097:blood; D008875:Middle Aged; D010266:Paraproteins / Q000032:analysis; D011239:Prednisolone / Q000627:therapeutic use; D011928:Raynaud Disease / Q000175:diagnosis
D018906:Antineoplastic Agents, Alkylating; D005938:Glucocorticoids; D007075:Immunoglobulin M; D007145:Immunoglobulin kappa-Chains; D010266:Paraproteins; D002699:Chlorambucil; D011239:Prednisolone