Primera serie de casos reportada en Colombia de la enfermedad por aglutininas frías primaria y secundaria. Experiencia de un centro de referencia en Medellín entre 2010 y 2017

Carlos José Atencia; Catalina Quintero

doi:10.17533/udea.iatreia.40

Authors

Carlos José Atencia University of Antioquia. San Vicente Foundation University Hospital https://orcid.org/0000-0002-4531-229X
Catalina Quintero University of Antioquia

DOI:

https://doi.org/10.17533/udea.iatreia.40

Keywords:

autoimmune hemolytic anemia, cold agglutinin disease, lymphoma, hematologic neoplasms, rituximab

Abstract

Introduction: Cold agglutinin disease (CAD) is a primary hematologic disorder or can be secondary to another disease. CAD is characterized by autoimmune hemolytic anemia associated with IgM type antibodies, at low temperatures. Clinically CAD is associated with cryoparesthesia and acrocyanosis induced by cold and fever, or it can be asymptomatic and can be detected by abnormalities on cell blood counts.

Objective: To describe the clinical and laboratory data and the etiology of CAD. Comparison between this case series and those described in the literature.

Materials and Methods: Retrospectively, we analyzed clinical data of patients from Hospital Universitario San Vicente Fundación with positive results for cold agglutinin assays made in the hematology lab from Universidad de Antioquia. We consider patients with titers ≥ 1:64 or Coombs test positive for cold antibodies.

Results: We describe clinical and laboratory findings included crioagglutinin titers of 23 cases with CAD: 6 of them with primary CAD, 4 with non-Hodgkin Lymphoma (NHL), 8 patients with CAD associated with infectious and autoimmune disease and 5 with CAD miscellaneous diseases.

Disscusion and Conclusions: This is the first CAD case series described in Colombia. Age and gender were like others case series. Most of patients presented with hemolityc anemia and cold related symptoms. The hemoglobin/ hematocrit ratio was 1:2. Secondary causes were vasculitis, lupus and malaria. Primary CAD were related to NHL, specifically limphoplasmocytic Most of the treatments of primary CAD included rituximab.

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Author Biographies

Carlos José Atencia, University of Antioquia. San Vicente Foundation University Hospital

Assistant professor. Internist.

Catalina Quintero, University of Antioquia

Microbiologist and Bioanalyst, MSc.

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