Cold agglutinin disease (CAD) is a rare autoimmune disease in which the immune system mistakenly attacks the red blood cells, causing them to lyse, or disintegrate, especially in colder temperatures.
What is joint pain?
Joint pain is defined as discomfort, pain, or inflammation at any of the body’s joints — including the shoulders, hips, knees, ankles, and wrists. In people with CAD, joint pain can be very mild or extremely severe. But it is often worse in the cold. Many patients learn to avoid cold exposure, even before receiving a diagnosis of CAD, because they have noticed that cold causes pain or discomfort in their joints.
What causes joint pain in CAD?
CAD is caused by the immune system producing antibodies against red blood cells. The binding of antibodies to red blood cells causes them to clump or aggregate before they are destroyed by the immune system. These clumps interfere with blood flow, and can block the small blood vessels. Places where blood vessels come together — such as the joints — can be particularly affected by CAD.
Joint pain may be caused by the accumulation of blood cells at the joints. Moreover, the over activation of the immune system can mean that it begins to attack other tissues — such as cartilage at the joints, either directly, by generating antibodies, or indirectly, by increasing the level of inflammation. This also can cause arthritis in joints in severe cases.
How is joint pain treated?
There are several treatment options for CAD. These treatments often relieve or prevent symptoms like joint pain, though patients also may need to be treated for the pain directly. If the pain is mild, patients may be treated with over-the-counter pain relief medications like ibuprofen (sold as Advil or Motrin, among others) or naproxen (available as Aleve, among others). For severe pain, people with CAD may be prescribed opioid narcotics, like codeine, oxycodone, or hydrocodone.
Last updated: August 13, 2019
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