Korean J Blood Transfus.  2015 Apr;26(1):75-80. 10.17945/kjbt.2015.26.1.75.

Therapeutic Plasma Exchange for a Patient with Severe Cold Agglutinin Disease

• Yang N
• Park S
• Chung HS
• Mun YC
• Yu S
• Kwon MJ
• Woo HY
• Oh S
• Lee M

• KMID: 2139829
• DOI: http://doi.org/10.17945/kjbt.2015.26.1.75

Abstract

Cold agglutinin disease is a kind of autoimmune hemolytic anemia, caused by cold agglutinin, serum autoantibodies activated at reduced body temperatures to produce red blood cell agglutination and hemolysis. In this paper we described a case of severe hemolytic anemia in a cold agglutinin disease patient treated with therapeutic plasma exchange. Therapeutic plasma exchanges were performed four times every other day. Over the same period, a total of 8 units of washed red blood cells were transfused. Then hemoglobin was increased from 4.0 g/dL to 7.8 g/dL. On the 12th hospital day hemoglobin level was decreased again to 4.2 g/dL and fludarabine chemotherapy was started on the 14th hospital day. The patient's symptoms were relieved and she was discharged on the 30th hospital day. As in this case, therapeutic plasma exchange could be considered as secondary therapy for temporary improvement of acute severe hemolytic anemia in cold agglutinin disease.

Keyword

Therapeutic plasma exchange; Cold agglutinin disease; Autoimmune hemolytic anemia

MeSH Terms

Agglutination
Anemia, Hemolytic
Anemia, Hemolytic, Autoimmune*
Autoantibodies
Body Temperature
Drug Therapy
Erythrocytes
Hemolysis
Humans
Plasma Exchange*
Autoantibodies