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BMJ Case Reports 2018; doi:10.1136/bcr-2017-222064
  • Unusual association of diseases/symptoms
  • CASE REPORT

Cold agglutinin-mediated autoimmune haemolytic anaemia associated with diffuse large B cell lymphoma

  1. Attaya Suvannasankha1,3
  1. 1Division of Hematology and Oncology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
  2. 2Department of Pathology, Indiana University School of Medicine, Indianapolis, Indiana, USA
  3. 3Division of Hematology and Oncology, Department of Medicine, Richard L Roudebush VA Medical Center, Indianapolis, Indiana, USA
  1. Correspondence to Dr Attaya Suvannasankha, asuvanna{at}iupui.edu
  • Accepted 20 June 2018
  • Published 10 July 2018

Summary

Cold agglutinin-mediated autoimmune haemolytic anaemia is associated with the development of autoantibodies that can agglutinate red blood cells at cold temperatures. While primary cold agglutinin disease is an idiopathic lymphoproliferative disorder, secondary cold agglutinin syndrome (CAS) complicates other diseases such as infections, autoimmune diseases and cancers, mostly low-grade lymphomas. Early recognition, treatment of CAS and treatment of its associated underlying diseases are crucial to a successful outcome. We report a case of CAS in a setting of diffuse large B cell lymphoma, in which the treatment course was complicated by worsened anaemia due to chemotherapy-induced myelosuppression. We reviewed previously reported cases and discussed diagnosis and treatment strategies, including novel complement inhibitors, as potential future therapy.

Footnotes

  • Contributors SW reviewed the medical literature, drafted the manuscript and approved the final manuscript as submitted. MC reviewed lymph node histopathology and confirmed immunohistochemical staining. AS was the primary treating subspecialty provider for the patients, revised the manuscript and approved the final manuscript as submitted. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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