Cold Agglutinin Disease in Children

Cold Agglutinin Disease in Children
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While the risk for cold agglutinin disease (CAD) increases after age 55, children occasionally develop the disorder. In these cases, CAD is usually the result of infection, lasts a relatively short time, and generally requires supportive care only.

What is CAD?

CAD is a type of autoimmune hemolytic anemia, in which the immune system produces antibodies called cold agglutinins. These antibodies mistakenly attack red blood cells at low temperatures and cause them to burst, a process called hemolysis.

The disease may manifest as a primary disease, in which the underlying cause is unclear, or as a secondary disease caused by underlying medical issues such as infections, certain types of cancer, or other autoimmune diseases.

Can children have CAD?

CAD is a relatively rare disorder in children that doctors most often diagnose after a recent infectious illness.

Researchers estimate the number of patients, from 11 to 20 years of age, with all types of autoimmune hemolytic anemia to be approximately 0.2 per 100,000.

How do doctors treat CAD in children?

Secondary CAD caused by a non-viral infection is usually transient, although antibiotics may be beneficial. These patients rarely need immunosuppressive treatment or plasmapheresis — a process that filters the blood and removes harmful antibodies — unless acute anemia is present.

What happened in some case studies?

A study reported the case of a girl, age 9, who developed cold agglutinin-induced acrocyanosis — a bluish skin discoloration due to the blockage of small blood vessels — after a respiratory infection. Doctors prescribed the girl an antibiotic and a medication to improve blood flow. They advised her to avoid cold and to keep her extremities warm. After six months, she showed only mild symptoms.

In another study, doctors diagnosed a girl, 8, with CAD apparently brought on by an acute Epstein-Barr virus infection. She recovered uneventfully after a three-week course of corticosteroid treatment.

Cases of cold antibody autoimmune hemolytic anemia secondary to infection are mostly mild and self-limiting. However, they can occasionally be severe. One study reported the case of a boy, 3, who had recently had an infection and was hospitalized with a fever and life-threatening acute hemolysis. Unresponsive to high-dose steroids and intravenous immunoglobulin, he recovered following plasmapheresis.

 

Last updated: Aug. 27, 2020

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Cold Agglutinin Disease News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Mary M. Chapman began her professional career at United Press International, running both print and broadcast desks. She then became a Michigan correspondent for what is now Bloomberg BNA, where she mainly covered the automotive industry plus legal, tax and regulatory issues. A member of the Automotive Press Association and one of a relatively small number of women on the car beat, Chapman has discussed the automotive industry multiple times of National Public Radio, and in 2014 was selected as an honorary judge at the prestigious Cobble Beach Concours d’Elegance. She has written for numerous national outlets including Time, People, Al-Jazeera America, Fortune, Daily Beast, MSN.com, Newsweek, The Detroit News and Detroit Free Press. The winner of the Society of Professional Journalists award for outstanding reporting, Chapman has had dozens of articles in The New York Times, including two on the coveted front page. She has completed a manuscript about centenarian car enthusiast Margaret Dunning, titled “Belle of the Concours.”
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Özge has a MSc. in Molecular Genetics from the University of Leicester and a PhD in Developmental Biology from Queen Mary University of London. She worked as a Post-doctoral Research Associate at the University of Leicester for six years in the field of Behavioural Neurology before moving into science communication. She worked as the Research Communication Officer at a London based charity for almost two years.
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Mary M. Chapman began her professional career at United Press International, running both print and broadcast desks. She then became a Michigan correspondent for what is now Bloomberg BNA, where she mainly covered the automotive industry plus legal, tax and regulatory issues. A member of the Automotive Press Association and one of a relatively small number of women on the car beat, Chapman has discussed the automotive industry multiple times of National Public Radio, and in 2014 was selected as an honorary judge at the prestigious Cobble Beach Concours d’Elegance. She has written for numerous national outlets including Time, People, Al-Jazeera America, Fortune, Daily Beast, MSN.com, Newsweek, The Detroit News and Detroit Free Press. The winner of the Society of Professional Journalists award for outstanding reporting, Chapman has had dozens of articles in The New York Times, including two on the coveted front page. She has completed a manuscript about centenarian car enthusiast Margaret Dunning, titled “Belle of the Concours.”
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