The term “cold agglutinin (CA)” refers to a group of disorders caused by anti-erythrocyte autoantibodies that preferentially bind RBCs at cold temperatures (4°C–18°C). CAs contribute to 10 to 15% of autoimmune hemolytic anemia. We report a case of CAs diagnosed intraoperatively during emergency mitral valve replacement.
Cold agglutinins (CAs) contribute to 10 to 15% of autoimmune hemolytic anemia. Manifestations, apart from anemia, may be in the form of acrocyanosis, Reynold’s phenomenon, livedo reticularis, or rarely gangrene. Some patients may remain asymptomatic until exposed to cold temperatures. Complications have been reported due to high titers of antibodies after febrile illness, trauma, or exposure to very low temperatures as occurs in surgeries requiring cardiopulmonary bypass.