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Case Reports
. 2025 May;41(5):582-586.
doi: 10.1007/s12055-024-01834-2. Epub 2024 Nov 11.

Cold agglutinin disease coexisting with left main coronary artery involvement and ventricular dysfunction - a challenging triad

Dhiren Shah  1 , Kishore Gupta  1 , Ankit Jitani  2 , Dhaval Naik  1 , Chintan Sheth  3
Affiliations
Case Reports

Cold agglutinin disease coexisting with left main coronary artery involvement and ventricular dysfunction - a challenging triad

Dhiren Shah et al. Indian J Thorac Cardiovasc Surg. 2025 May.

Abstract

Cold hemagglutinin disease (CHAD) is a rare autoimmune condition characterized by cold-reactive antibodies causing hemagglutination and complement-mediated hemolysis. This case report details the successful management of a 56-year-old male with CHAD, coronary artery disease, and left ventricular dysfunction. The patient underwent coronary artery bypass grafting (CABG) amid challenges, including a rapid drop in hemoglobin levels, limited compatible blood supply, and cardiac comorbidities. Treatment involved rituximab, bortezomib, and a meticulous perioperative protocol to prevent hypothermia. The multidisciplinary approach, including hematologists, anesthetists, and surgeons, played a crucial role in managing the triad highlighting the importance of tailored management in CHAD cases.

Keywords: Cold hemagglutinin disease; Cold-reactive antibodies; Coronary artery bypass grafting.

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Conflict of interest statement

Conflict of interestNone.

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