Vol.19 No.4

Case Report

A case of cold agglutinin disease in the course of treatment for polymyalgia rheumatica

Authors

Hideki Nakamura1 , Kayo Kamiya-Matsumoto1 , Atsushi Kawakami1 , Hiroaki Ida1 , Tomayoshi Hayashi2 , Shinichi Sato3 , Shimeru Kamihira4 , Katsumi Eguchi1

  • Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki Nagasaki, 852-8501, Japan
  • Department of Pathology, Nagasaki University Hospital, Nagasaki, Japan
  • Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
  • Central Diagnostic Laboratory, Nagasaki University Hospital, Nagasaki, Japan
Received:

19 January 2009

Accepted:

10 March 2009

Published online:

2 April 2009

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Abstract

A 60-year-old male who had been treated for polymyalgia rheumatica (PMR) with Raynaud’s phenomenon was admitted to our hospital with acrocyanosis and rapid progressive anemia. Hemolytic anemia with reduction of haptoglobin and cold agglutinin was detected, and the patient had a negative Donath-Landsteiner test. A skin biopsy from his toe revealed microthromboembolism without vasculitis, resulting in the diagnosis of cold agglutinin disease (CAD). This is a first case report of CAD complicated with PMR.

Key words

Cold agglutinin disease - Hemolytic anemia - Polymyalgia rheumatica - Raynaud’s phenomenon