Which physical findings are characteristic of cold agglutinin disease?

Updated: Aug 28, 2018
  • Author: Salman Abdullah Aljubran, MD; Chief Editor: Michael A Kaliner, MD  more...
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Physical examination may reveal nothing unusual or only pallor, unless the patient is observed during or shortly after cold exposure. Purplish discoloration of the ears, forehead, tip of the nose, and digits may then be seen. Livedo reticularis has been observed as well. Ischemic necrosis can lead to pain, but skin ulceration secondary to ischemia is uncommon.

Splenomegaly and jaundice, characteristic of lymphoproliferative disorders or infectious mononucleosis, are usually absent, but they may sometimes be observed in patients with chronic cold agglutinin disease.

Lymphadenopathy, fever, or both may be present in patients with lymphoma, infectious mononucleosis, or other infections.

Pulmonary signs, such as rales and fever, may be found in patients with Mycoplasma pneumonia. [27, 15]  Other findings, including hepatomegaly, relate to the presence of underlying or associated disease states. Signs of congestive heart failure or shock are rare but may be present when anemia is severe.

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