phenylephrine-hydrochloride and Anemia--Hemolytic--Autoimmune

Cold agglutinin disease (CAD) is a rare condition leading to blood agglutination and autoimmune hemolytic anemia. Cutaneous ischemia resulting from CAD in the head and neck is uncommon. Treatment regimens and outcomes vary widely in the literature and no clear protocol exists. This manuscript describes a patient with CAD who developed severe ischemia of the nose that resolved completely without sequellae following a medical regimen of aspirin, low molecular weight heparin, nitroglycerin ointment and hyperbaric oxygen therapy (HBOT). To our knowledge, this is the first reported case where nitroglycerin ointment or HBOT was successfully employed in the treatment of this complication.

Topics: Administration, Topical; Aged, 80 and over; Anemia, Hemolytic, Autoimmune; Anticoagulants; Combined Modality Therapy; Enoxaparin; Female; Humans; Hyperbaric Oxygenation; Ischemia; Nitroglycerin; Nose; Ointments; Vasodilator Agents

We present the case of a woman where the diagnosis of cold agglutinin disease could be made after we had noticed slight cutaneous manifestations during a routine examination. Leading symptoms were livedo reticularis of the thighs and a history of acrocyanosis and Raynaud's phenomenon upon cold exposure. The current knowledge about the etiology, clinical presentation and treatment of the disease is briefly discussed.

Topics: Anemia, Hemolytic, Autoimmune; Cyanosis; Diagnosis, Differential; Ear, External; Female; Humans; Middle Aged; Nose; Raynaud Disease; Skin Diseases, Vascular; Thigh