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A novel method for demonstrating cold agglutinin disease: a case report
Thomas A Vo1, Zack Oakey1, Yasir A Khan2
1Gavin Herbert Eye Institute, University of California, 850 Health Sciences Rd, Irvine, CA, 92697, USA.
Journal of Medical Case Reports
|April 19, 2018
Summary
Cold agglutinin disease (CAD) diagnosis can be aided by observing cold agglutination reactions in conjunctival vessels during cataract surgery. This novel method offers a rapid, alternative screening tool for CAD.
Area of Science:
- Ophthalmology
- Hematology
- Immunology
Background:
- Cold agglutinin disease (CAD) is a rare autoimmune hemolytic anemia triggered by low temperatures.
- Diagnosis typically involves physical findings like acrocyanosis and thermal amplitude testing.
- Thermal amplitude testing identifies the highest temperature at which cold agglutination occurs.
Observation:
- A 57-year-old patient with known chronic CAD presented for cataract surgery.
- During surgery, balanced salt solution at room temperature lowered conjunctival temperature.
- This induced a visible cold agglutination reaction in conjunctival vessels under a surgical microscope.
Findings:
- The intraoperative observation demonstrated a cold agglutination reaction in conjunctival vessels.
- This reaction was readily visible using a surgical microscope.
Implications:
- This observation presents a novel, easily performed method for demonstrating CAD.
- Utilizing an ordinary slit lamp, this technique could serve as a rapid screening tool.
- This approach offers a potential alternative diagnostic method for cold agglutinin disease.
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