Severe Anemia Due to Cold Agglutinin Syndrome in a COVID-19 Patient with IgM Monoclonal Gammopathy of Undetermined Significance Successfully Treated with Corticosteroids

Intern Med. 2022 Jun 1;61(11):1789-1793. doi: 10.2169/internalmedicine.8647-21. Epub 2022 Mar 26.

Abstract

Secondary cold agglutinin syndrome (CAS) is autoimmune hemolytic anemia secondary to infections and lymphoid disorder. We here report the first Asian case of CAS secondary to novel coronavirus disease 2019 (COVID-19). A 72-year-old Japanese woman presented with a 2-week history of dyspnea and cough, and laboratory data revealed severe hemolytic anemia with a hemoglobin level of 4.7 g/dL. She was diagnosed with COVID-19, CAS, and monoclonal gammopathy of undetermined significance (MGUS). The anemia responded to corticosteroids administered for COVID-19 and required maintenance therapy. Although corticosteroids are not a standard therapy for CAS, they might be effective for CAS secondary to COVID-19 complicated with MGUS.

Keywords: COVID-19; autoimmune hemolytic anemia; cold agglutinin syndrome; corticosteroid; monoclonal gammopathy of undetermined significance.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Aged
  • Anemia, Hemolytic, Autoimmune* / complications
  • Anemia, Hemolytic, Autoimmune* / drug therapy
  • COVID-19* / complications
  • Cryoglobulins
  • Female
  • Humans
  • Immunoglobulin M
  • Monoclonal Gammopathy of Undetermined Significance* / complications
  • Monoclonal Gammopathy of Undetermined Significance* / diagnosis
  • Monoclonal Gammopathy of Undetermined Significance* / drug therapy

Substances

  • Adrenal Cortex Hormones
  • Cryoglobulins
  • Immunoglobulin M
  • cold agglutinins