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Cold agglutinin syndrome: What are the symptoms?

What are the symptoms of cold agglutinin syndrome? What exactly are cold agglutinins?

- Shirley / Canada

Mayo Clinic hematologist Ruben Mesa, M.D., and colleagues answer select questions from readers.

Answer

Cold agglutinins are abnormal proteins in your blood. These proteins act as antibodies, causing your red blood cells to clump together and die prematurely — especially when your body is exposed to temperatures colder than normal body temperature. Most healthy people have a small number of cold agglutinins. Cold agglutinin syndrome occurs when you have high numbers of cold agglutinins. This can lead to a form of destructive (hemolytic) anemia, in which red blood cells are destroyed faster than bone marrow can replace them.

Signs and symptoms of cold agglutinin syndrome include:

  • Color changes in the skin on your nose, ears, lips, hands and feet in response to cold (Raynaud's phenomenon)
  • Painful fingers and toes with cold exposure
  • Death of tissue due to insufficient blood supply to that tissue (ischemic necrosis)

The cause of cold agglutinin syndrome is unknown. A doctor can confirm a diagnosis of cold agglutinin syndrome by blood tests. Treatment may include:

  • Avoiding extremely cold temperatures
  • Chemotherapy

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May 9, 2008