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Case report
Cold agglutinin disease and COVID-19 requiring therapeutic plasma exchange
  1. Yousuf Ahmed1,
  2. Aditi Khandelwal2,3 and
  3. Laura Walker1,4
  1. 1University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
  2. 2Division of Haematology and Medical Oncology, Department of Medicine, St Michael's Hospital, Toronto, Ontario, Canada
  3. 3Medical Services & Hospital Relations, Canadian Blood Services, Toronto, Ontario, Canada
  4. 4Department of Medicine, St Michael's Hospital, Toronto, Ontario, Canada
  1. Correspondence to Dr Laura Walker; laura.walker{at}mail.utoronto.ca

Abstract

A 70-year-old man with known cold autoimmune haemolytic anaemia was referred to the emergency department with increased shortness of breath on exertion. He had been confirmed positive for non-variant COVID-19 infection 1 week earlier based on nasopharyngeal swab PCR assay. CT thorax demonstrated diffuse patchy bilateral ground glass opacities, consistent with COVID-19 pneumonia. Bloodwork demonstrated severe cold agglutinin mediated haemolytic anaemia. To help stabilise the patient, he was transferred to a tertiary care hospital for urgent therapeutic plasma exchange. Key supportive therapy included folic acid supplementation, ensuring the patient was kept warm and warmed infusions including transfusions via the apheresis machine. The patient made a good recovery following plasma exchange, and his haemoglobin levels remained stable by discharge.

  • COVID-19
  • haematology (incl blood transfusion)
  • haematology (drugs and medicines)

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bcr-2021-244227

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    Footnotes

    • Contributors Data collection, drafting the article: YA. Critical revision of the article: YA, AK and LW. Final approval of the version to be published: YA, AK and LW.

    • 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.

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