Cold agglutinin
Autoimmune hemolytic anemia of Cold type
The Cold agglutinin is based on the binding of antibodies to the red blood cells (erythrocytes) at temperatures below the physiological body temperature at the cold, exposed body parts.
By these antibodies leads to agglutination (clumping) of red cells so that clog blood vessels below the "" and the affected parts can not be adequately supplied with blood.
Normally all people have antibodies in their blood cold. But here are only relatively few, so that the above-described reaction takes place only at temperatures below four degrees Celsius.
When Kälteagglutininsyndrom however, more antibodies are present, so that the agglutination even at a drop in temperature in the blood vessels to 20-25 degrees comes.
In the very rare congenital Cold agglutinin antibodies levels are so high that even at temperatures around 30 degrees to the agglutination occurs, so that these people stay in a cold climate are not possible.
Symptoms of cold exposure:
- Blue discoloration and pain in the fingers and toes, where appropriate, which are reversible with rewarming.
- Anemia by the lack of available number of erythrocytes
- Problems in the blood by a blockage of the needle may strike as indirect evidence.
Complications
During the Cold agglutinin disease can occur when cold exposure haemolytic crises. These manifest themselves, inter alia, by fever, jaundice (jaundice), and a sudden Kollapsder patients.
Diagnosis
- Initial guidance is often already in the history of the patient
- Consideration of possible indirect sign (see above).
- The detection of antibodies
Therapy
A causal therapy is unfortunately not available
symptomatic:
- Protection from the cold
- with serious hemolytic anemia may be useful immunosuppressants
- may be required in severe cases plasmapheresis (removal of the antibodies in the blood)
- before surgery in hypothermia (cooling of the body, for example, a heart surgery to avoid damage to the tissues) should be done in any case, a clarification on any existing cold antibodies