A Case Report of Cold Agglutinin Disease, Severe B12 Deficiency, and Pernicious Anemia: A Deadly Coincidence

Abstract

Anemia is the most common hematological disorder. It is commonly a manifestation of an underlying disease. Its causes are multifactorial, including but not limited to nutritional deficiencies, chronic conditions, inflammatory processes, medications, malignancy, renal dysfunction, hereditary diseases, and bone marrow disorders. We present a case of a patient exhibiting anemia related to cold agglutin disease and severe B12 deficiency secondary to pernicious anemia.

The Importance of Early Suspicion for Cold Autoimmune Hemolytic Anemia

“…Other cases of CAD presenting as cAIHA demonstrated a similar presentation as our case, with fatigue, jaundice, dark urine consistent with hemoglobinuria, and general malaise. However, unlike our case, both cases had a stable hospital course and were ultimately resolved with high-dose steroids during inpatient care, leading to discharge on a course of oral steroids [ 17 , 18 ]. As can be seen in our case, the delay in diagnosis and lab results due to severe hemolysis allowed for further rapid progression of our patient’s condition.…”