Korean J Blood Transfus.  2009 Dec;20(3):253-257.

A Case of Cold Agglutinin Disease Accompanied by Bacterial Pneumonia That Was Treated with Rituximab

Affiliations
  • 1Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea. hmaeng@gmail.com
  • 2Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 3Department of Laboratory Medicine, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.
  • 4Current Affiliation is Mt. Vernon Hospital, Mt. Vernon, NY, USA.

Abstract

Cold agglutinin disease (CAD) is a small group of disorders that is characterized by cold-reactive autoantibodies that bind to erythrocyte carbohydrate antigens, and this causes hemagglutination and complement-mediated hemolysis. Autoimmune hemolytic anemia (AIHA) is an immune disorder that is mediated via auto-antibodies produced by lymphoid B cells against red blood cells. The disorder may be a primary (idiopathic) or secondary disease with an underlying autoimmune disease, a lymphoproliferative disorder or infection. The mainstay of initial treatment is immunosuppression with glucocorticosteroids. For those who do not have satisfactory response to initial glucocorticosteroids or they have a relapse after initially successful treatment, splenectomy or other immunosuppressive agents such as azathioprine, cyclosporine and intravenous immunoglobulin (IVIG) could be the next available options. More recently, rituximab, which is a human-murine chimeric monoclonal antibody specific for the CD20 antigen found on the surface of B lymphocytes, is also available. We report here on the successful use of rituximab for the treatment of a Korean elderly patient with CAD and the patient presented with recurrent AIHA.

Keyword

Cold agglutinin disease; Autoimmune hemolytic anemia; Rituximab

MeSH Terms

Aged
Anemia, Hemolytic, Autoimmune
Antibodies, Monoclonal, Murine-Derived
Antigens, CD20
Autoantibodies
Autoimmune Diseases
Azathioprine
B-Lymphocytes
Cold Temperature
Cyclosporine
Erythrocytes
Hemagglutination
Hemolysis
Humans
Immune System Diseases
Immunoglobulins
Immunosuppression
Immunosuppressive Agents
Lymphoproliferative Disorders
Pneumonia, Bacterial
Recurrence
Splenectomy
Rituximab
Antibodies, Monoclonal, Murine-Derived
Antigens, CD20
Autoantibodies
Azathioprine
Cyclosporine
Immunoglobulins
Immunosuppressive Agents
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