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Case Reports
. 2021 Apr 16;15(1):169.
doi: 10.1186/s13256-021-02784-8.

Cold agglutinin-induced hemolytic anemia during room temperature fluid resuscitation: a case report

Yosuke Kawai  1 , Miyoshi Deguchi  2 , Naoko Mizouchi  2 , Satoru Yoshida  2 , Ken Kumagai  2 , Yasuo Hirose  2
Affiliations
Case Reports

Cold agglutinin-induced hemolytic anemia during room temperature fluid resuscitation: a case report

Yosuke Kawai et al. J Med Case Rep. .

Abstract

Background: Cold agglutinin disease can cause the agglutination of red blood cells and hemolytic anemia due to cold temperature. Herein, we report a case of progressive hemolytic anemia due to cold agglutinin disease during fluid resuscitation and in the absence of exposure to cold.

Case presentation: A 71-year-old Japanese man was admitted to the emergency department with signs of hypotension and disturbed consciousness. He was diagnosed with diabetic ketoacidosis, and treatment with fluid resuscitation and insulin infusion was initiated. Laboratory test results obtained the following day indicated hemolytic anemia. On day 5 after admission, red blood cell agglutination was detected, and the patient was diagnosed with cold agglutinin disease.

Conclusions: Cold agglutinin disease should be considered in the differential diagnosis of progressive hemolytic anemia during fluid resuscitation, even if the solution is at room temperature.

Keywords: Cold agglutinin disease; Diabetic ketoacidosis; Fluid resuscitation; Hemolytic anemia; Intensive care.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Peripheral blood smear showing red blood cell agglutination (arrow)
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