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The most common antibody isotype involved in warm antibody AIHA is IgG, though sometimes IgA is found. The IgG antibodies attach to a red blood cell, leaving their F C portion exposed with maximal reactivity at 37 °C (versus cold antibody induced hemolytic anemia whose antibodies only bind red blood cells at low body temperatures, typically 28–31 °C).
Symptoms of AIHA may be due to the underlying anemia; including shortness of breath or dyspnea, fatigue, headache, muscle weakness and pallor. [10] In cold agglutinin disease (cold antibody type), agglutination and impaired passage of red blood cells through capillaries in the extremities causes acrocyanosis and Raynaud phenomenon with a rare complication of gangrene [4]
Cold agglutinins develop in more than 60% of patients with infectious mononucleosis, but hemolytic anemia is rare. Classic chronic cold agglutinin disease is idiopathic, associated with symptoms and signs in relation to cold exposure.
Cold agglutinin disease (CAD) is a rare autoimmune disease characterized by the presence of high concentrations of circulating cold sensitive antibodies, usually IgM and autoantibodies that are also active at temperatures below 30 °C (86 °F), [1] directed against red blood cells, causing them to agglutinate and undergo lysis. [2]
Immune-mediated causes could include transient factors as in Mycoplasma pneumoniae infection (cold agglutinin disease) [14] or permanent factors as in autoimmune diseases like autoimmune hemolytic anemia [15] (itself more common in diseases such as systemic lupus erythematosus, rheumatoid arthritis, Hodgkin's lymphoma, and chronic lymphocytic ...
Mixed autoimmune hemolytic anemia (MAIHA) is a type of autoimmune hemolytic anemia which combines the features of cold sensitive antibody-induced diseases and warm autoimmune hemolytic anemia. The work-up for diagnosis is complex and the condition can be over-diagnosed. [1] [2] [better source needed] People diagnosed with warm autoimmune ...