ISSN 2398-2969      

Skin: cold agglutinin disease

icanis

Introduction

  • Rare.
  • Cause: agglutination of erythrocytes and microthrombus formation in capillary walls.
  • Signs: erythema, purpura and necrosis of extremities.
  • Diagnosis: signs and cold agglutinin test.
  • Treatment: management of temperature and underlying disease.
  • Prognosis: good if tissue destruction not too severe.

Pathogenesis

Etiology

  • Type II hypersensitivity → idiopathic but may be associated with lead poisoning Lead toxicity.

Predisposing factors

General
  • Cold temperatures increase activity of agglutinins.
  • Poor husbandry and cold weather.
  • Lead poisoning.

Pathophysiology

  • Auto-immune disease → cold reacting IgM erythrocyte auto-antibodies → cryoglobulin and cryofibrinogens precipitated in tissue → microthrombi and vasculitis → tissue necrosis.
  • Idiopathic auto-immune disease.
  • Cold reacting IgM erythrocyte auto-antibody → agglutination and hemolysis.
  • Cold reacting auto-antibody most active at 0-4°C, but may be active at higher temperatures.
  • Thrombi in capillaries → hypoxia and necrosis of tissues.

Timecourse

  • Acute onset but signs may be insidious.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Burgess K, Moore A, Rand W & Cotter S M (2000) Treatment of immune-mediated hemolytic anemia in dogs with cyclophosphamide. J Vet Intern Med 14 (4), 456-462 PubMed.
  • White S D (1994) Diseases of the nasal planum. Vet Clin North Am 24 (5), 887-895 PubMed.
  • Dickson N J (1990) Cold agglutinin disease in a puppy associated with lead intoxication. JSAP 31 (2), 105-8 VetMedResource.
  • Hasegawa T, Matsuoka K, Ono K et al (1990) Immune-mediated skin lesions in a dog with auto-immune hemolytic anemia. Nippon Juigaku Zasshi 52 (5), 1001-1006 PubMed.

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