What is included in the long-term monitoring of patients with cold agglutinin disease?

Updated: Aug 28, 2018
  • Author: Salman Abdullah Aljubran, MD; Chief Editor: Michael A Kaliner, MD  more...
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Answer

Long-term follow-up care, with or without therapy, is a vital aspect of managing cold agglutinin disease. Vigilance for the development of systemic symptoms of any lymphoproliferative disorder is necessary. Follow-up also includes monitoring for infection, declining renal function, and evidence of ischemia. Among the findings that indicate the need for follow-up care are the following:

  • Postinfectious anemia
  • Infectious mononucleosis
  • Mycoplasma pneumoniae infection
  • Acrocyanosis
  • Cold-precipitated symptoms

Monitor patients periodically for signs of worsening or improvement that might prompt changes in management. The frequency of reassessment varies with the severity of the disease. Periodic checkups may vary from daily to weekly to monthly and may eventually occur as infrequently as every 2-3 months. Make reevaluations more often in colder weather than in warmer weather.

The following tests can be performed weekly until the patient’s condition is stable:

  • Clinical examination
  • Complete blood cell count (CBC)
  • Reticulocyte count
  • Urinalysis

The following tests can be performed monthly until the cold agglutinin disease has resolved:

  • Clinical examination
  • CBC
  • Reticulocyte count
  • Urinalysis
  • Direct antiglobulin test
  • Cold agglutinin titer

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