Major colorectal surgery in a patient with cold agglutinin disease

Young, Si Ling; Haldane, Grant J.

doi:10.1111/j.1365-2044.2006.04650.x

Cited by 11 publications

(11 citation statements)

References 14 publications

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“…32,153 Multiple reports describe an association between acrocyanosis and cold agglutinins, cryoglubulins, or cryofibrinogen. 28,33,154–156 Almost a third of all patients with positive antiphospholipid antibodies have acrocyanosis. 30,40,157,158 Anti-cardiolipin antibodies have been reported in patients with acrocyanosis.…”

Section: Secondary Acrocyanosismentioning

confidence: 99%

Acrocyanosis: The Flying Dutchman

2011

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Acrocyanosis is symmetric, painless, discoloration of different shades of blue in the distal parts of the body that is marked by symmetry, relative persistence of the skin color changes with aggravation by cold exposure, and frequent association with local hyperhidrosis of hands and feet. Described over a century ago and despite seeming familiarity, it remains a poorly understood condition that shares much in clinical presentation with other conditions characterized by skin color changes in the distal parts of the body. The diagnosis remains mostly clinical, and pathological mechanisms vary suggesting that acrocyanosis may not be a single entity. We performed an extensive literature review to summarize existing knowledge about the demographics, pathology, diagnosis, and treatment of this condition.

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Section: Secondary Acrocyanosismentioning

confidence: 99%

Acrocyanosis: The Flying Dutchman

2011

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“…During general anesthesia, heat is lost in a number of ways; predominantly by surface cooling through radiation and convection mechanisms, accounting for up to 40% and 30% of heat loss, respectively. [ 2 ] In light of recognition of these factors, simple measures such as forced-air warming blankets are being increasingly utilised, especially in long duration vascular, plastic, and neurosurgeries to limit the heat loss. However, presence of CAs in surgeries involving deliberate hypothermia, such as cardiac surgery and renal transplantation, pose unique anaesthetic challenges.…”

Section: Discussionmentioning

confidence: 99%

Anaesthetic management for cardiac surgery in patients with cold haemagglutinin disease

et al. 2018

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Cold haemagglutination is a primary or acquired autoimmune disease involving antibodies that lead to agglutination of red blood cells at low temperature followed by complement fixation and haemolysis on rewarming. This disease can lead to adverse consequences in patients undergoing cardiothoracic surgery, especially when hypothermic cardiopulmonary bypass is applied. The authors discuss the management of two patients who underwent mitral valve replacement surgery while cold agglutinins were detected in the perioperative period. In the first patient, the diagnosis was made preoperatively followed by administration of glucocorticoids to achieve acceptable level of antibody titers. The second patient experienced haemoglobinuria during her intensive care unit stay. The case report describes the pathophysiology of cold agglutination, relevant laboratory investigations such as antibody titers and thermal amplitude, identification of at-risk patients, and management strategies to avoid serious complications.

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“…Other authors have previously reported suggestions for the perioperative management during the care of patients with CAD (Table 1) [14][15][16][17][18]. When CAD follows an infectious etiology, elective and non-urgent procedures should be postponed as the antibody titer can be expected to decline over 4 -8 weeks.…”

Section: Discussionmentioning

confidence: 99%

“…Young et al [14] A 62-year-old male with long-standing, cold agglutinin disease, diabetes mellitus, ischemic heart disease with previous coronary stenting, B-cell in remission, and OSA for an abdomino-peroneal excision of the rectum for a Duke's stage A low rectal carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Detection of Cold Agglutinins During Cardiopulmonary Bypass in a Child

et al. 2015

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Cold agglutinins are auto-antibodies, usually of the IgM class, that are present in low titers in the blood of normal individuals. They are generally of no clinical significance in healthy patients because they are active only at extremely low temperatures (less than 10 °C). However, when present in high titers, during periods of hypothermia, they may have clinical impact. We present a child presenting for surgery for congenital heart disease, in whom blood agglutination was noted during hypothermia while on cardiopulmonary bypass (CPB). The history of cold agglutinin disease is presented, typical clinical manifestations are discussed, and options for perioperative care including the conduct of CPB are presented.

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Major colorectal surgery in a patient with cold agglutinin disease

Cited by 11 publications

References 14 publications

Acrocyanosis: The Flying Dutchman

Acrocyanosis: The Flying Dutchman

Anaesthetic management for cardiac surgery in patients with cold haemagglutinin disease

Intraoperative Detection of Cold Agglutinins During Cardiopulmonary Bypass in a Child

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