Cold Agglutinin Disease–Associated Transient Ischemic Attack, Non-ST Elevation Myocardial Infarction, and Skin Necrosis: A Case Report

Cold agglutinin disease is a rare autoimmune hemolytic anemia that preferentially affects female patients and is more common in those older than 60 years. The pathophysiology involves IgM autoantibodies against erythrocytes in areas of the body at cooler temperatures, causing thrombosis and hemolysi...

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Main Authors: David Aziz, Rachel Parks, Ashley Barras, George Mina, Christopher Haas, Suraj Jande
Format: Article
Language:English
Published: American College of Physicians 2023-08-01
Series:Annals of Internal Medicine: Clinical Cases
Online Access:https://www.acpjournals.org/doi/10.7326/aimcc.2022.0909
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author David Aziz
Rachel Parks
Ashley Barras
George Mina
Christopher Haas
Suraj Jande
author_facet David Aziz
Rachel Parks
Ashley Barras
George Mina
Christopher Haas
Suraj Jande
author_sort David Aziz
collection DOAJ
description Cold agglutinin disease is a rare autoimmune hemolytic anemia that preferentially affects female patients and is more common in those older than 60 years. The pathophysiology involves IgM autoantibodies against erythrocytes in areas of the body at cooler temperatures, causing thrombosis and hemolysis. We present the case of a 66-year-old man who was found to have cold agglutinin disease and initially presented with altered mental status, stroke-like symptoms, and non-ST elevation myocardial infarction. Overnight, he also developed striking soft-tissue necrosis of his bilateral feet due to microvascular occlusion. His altered mentation and cardiac ischemia completely resolved; however, he eventually required bilateral phalangeal amputation.
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publishDate 2023-08-01
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series Annals of Internal Medicine: Clinical Cases
spelling doaj-art-e053d16d10584019a507c24bf0b37f9a2025-08-20T03:18:11ZengAmerican College of PhysiciansAnnals of Internal Medicine: Clinical Cases2767-76642023-08-012810.7326/aimcc.2022.0909Cold Agglutinin Disease–Associated Transient Ischemic Attack, Non-ST Elevation Myocardial Infarction, and Skin Necrosis: A Case ReportDavid Aziz0Rachel Parks1Ashley Barras2George Mina3Christopher Haas4Suraj Jande51Louisiana State University Health Sciences Center at Shreveport. Department of Internal Medicine, Shreveport, Louisiana1Louisiana State University Health Sciences Center at Shreveport. Department of Internal Medicine, Shreveport, Louisiana1Louisiana State University Health Sciences Center at Shreveport. Department of Internal Medicine, Shreveport, Louisiana1Louisiana State University Health Sciences Center at Shreveport. Department of Internal Medicine, Shreveport, Louisiana1Louisiana State University Health Sciences Center at Shreveport. Department of Internal Medicine, Shreveport, Louisiana1Louisiana State University Health Sciences Center at Shreveport. Department of Internal Medicine, Shreveport, LouisianaCold agglutinin disease is a rare autoimmune hemolytic anemia that preferentially affects female patients and is more common in those older than 60 years. The pathophysiology involves IgM autoantibodies against erythrocytes in areas of the body at cooler temperatures, causing thrombosis and hemolysis. We present the case of a 66-year-old man who was found to have cold agglutinin disease and initially presented with altered mental status, stroke-like symptoms, and non-ST elevation myocardial infarction. Overnight, he also developed striking soft-tissue necrosis of his bilateral feet due to microvascular occlusion. His altered mentation and cardiac ischemia completely resolved; however, he eventually required bilateral phalangeal amputation.https://www.acpjournals.org/doi/10.7326/aimcc.2022.0909
spellingShingle David Aziz
Rachel Parks
Ashley Barras
George Mina
Christopher Haas
Suraj Jande
Cold Agglutinin Disease–Associated Transient Ischemic Attack, Non-ST Elevation Myocardial Infarction, and Skin Necrosis: A Case Report
Annals of Internal Medicine: Clinical Cases
title Cold Agglutinin Disease–Associated Transient Ischemic Attack, Non-ST Elevation Myocardial Infarction, and Skin Necrosis: A Case Report
title_full Cold Agglutinin Disease–Associated Transient Ischemic Attack, Non-ST Elevation Myocardial Infarction, and Skin Necrosis: A Case Report
title_fullStr Cold Agglutinin Disease–Associated Transient Ischemic Attack, Non-ST Elevation Myocardial Infarction, and Skin Necrosis: A Case Report
title_full_unstemmed Cold Agglutinin Disease–Associated Transient Ischemic Attack, Non-ST Elevation Myocardial Infarction, and Skin Necrosis: A Case Report
title_short Cold Agglutinin Disease–Associated Transient Ischemic Attack, Non-ST Elevation Myocardial Infarction, and Skin Necrosis: A Case Report
title_sort cold agglutinin disease associated transient ischemic attack non st elevation myocardial infarction and skin necrosis a case report
url https://www.acpjournals.org/doi/10.7326/aimcc.2022.0909
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