tetano
Editor, Senior Moderator
Eur J Case Rep Intern Med
. 2021 Mar 10;8(3):002387.
doi: 10.12890/2021_002387. eCollection 2021.
Coronavirus Disease 2019 and Cold Agglutinin Syndrome: An Interesting Case
Ruby Gupta[SUP] 1 [/SUP], Sukhmani Singh[SUP] 1 [/SUP], Nwabundo Anusim[SUP] 1 [/SUP], Sachin Gupta[SUP] 2 [/SUP], Sorab Gupta[SUP] 3 [/SUP], Marianne Huben[SUP] 1 [/SUP], George Howard[SUP] 1 [/SUP], Ishmael Jaiyesimi[SUP] 1 [/SUP]
Affiliations
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has caused significant morbidity and mortality worldwide. While patients with COVID-19 most frequently present with pneumonia, respiratory failure and acute respiratory distress syndrome, increasing cases of immune-mediated disorders such as autoimmune thrombocytopenia, haemolytic anaemia and antiphospholipid syndrome have been reported. In this article we describe a rare case of cold agglutinin syndrome (CAS) in a patient with COVID-19. The patient was a 77-year-old man with a history of glucose-6-phosphate dehydrogenase (G6PD) deficiency who presented with COVID-19 infection and acute respiratory failure. Initially he was started on intravenous steroids, antibiotics and hydroxychloroquine. Laboratory analysis revealed haemolytic anaemia with a positive direct anti-globulin test (DAT) and high titres of cold agglutinins. Hydroxychloroquine was stopped due to suspicion of haemolysis due to G6PD deficiency but the haemolysis persisted. Unfortunately, the respiratory failure progressed and the patient died. In summary, this article describes a rare case of CAS associated with COVID-19. CAS is a heterogenous group of cold autoimmune haemolytic anaemias occurring secondary to infections or malignancies. No definite treatment for CAS in COVID-19 patients has been approved so far.
Learning points: Autoimmune haemolytic anaemia has been reported in COVID-19 patients.Cold agglutinin syndrome (CAS) can occur in patients with COVID-19.Efforts to determine the optimal management of CAS in COVID-19 patients must continue.
Keywords: Coronavirus disease 2019; autoimmune hemolytic anemia; case report; cold agglutinin syndrome.
. 2021 Mar 10;8(3):002387.
doi: 10.12890/2021_002387. eCollection 2021.
Coronavirus Disease 2019 and Cold Agglutinin Syndrome: An Interesting Case
Ruby Gupta[SUP] 1 [/SUP], Sukhmani Singh[SUP] 1 [/SUP], Nwabundo Anusim[SUP] 1 [/SUP], Sachin Gupta[SUP] 2 [/SUP], Sorab Gupta[SUP] 3 [/SUP], Marianne Huben[SUP] 1 [/SUP], George Howard[SUP] 1 [/SUP], Ishmael Jaiyesimi[SUP] 1 [/SUP]
Affiliations
- PMID: 33987115
- PMCID: PMC8112099
- DOI: 10.12890/2021_002387
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has caused significant morbidity and mortality worldwide. While patients with COVID-19 most frequently present with pneumonia, respiratory failure and acute respiratory distress syndrome, increasing cases of immune-mediated disorders such as autoimmune thrombocytopenia, haemolytic anaemia and antiphospholipid syndrome have been reported. In this article we describe a rare case of cold agglutinin syndrome (CAS) in a patient with COVID-19. The patient was a 77-year-old man with a history of glucose-6-phosphate dehydrogenase (G6PD) deficiency who presented with COVID-19 infection and acute respiratory failure. Initially he was started on intravenous steroids, antibiotics and hydroxychloroquine. Laboratory analysis revealed haemolytic anaemia with a positive direct anti-globulin test (DAT) and high titres of cold agglutinins. Hydroxychloroquine was stopped due to suspicion of haemolysis due to G6PD deficiency but the haemolysis persisted. Unfortunately, the respiratory failure progressed and the patient died. In summary, this article describes a rare case of CAS associated with COVID-19. CAS is a heterogenous group of cold autoimmune haemolytic anaemias occurring secondary to infections or malignancies. No definite treatment for CAS in COVID-19 patients has been approved so far.
Learning points: Autoimmune haemolytic anaemia has been reported in COVID-19 patients.Cold agglutinin syndrome (CAS) can occur in patients with COVID-19.Efforts to determine the optimal management of CAS in COVID-19 patients must continue.
Keywords: Coronavirus disease 2019; autoimmune hemolytic anemia; case report; cold agglutinin syndrome.