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What are some common symptoms of cold agglutinin disease?
In CAD, the binding of cold agglutinin antibodies to healthy red blood cells can have a few consequences. The binding of these antibodies to the red blood cells triggers the classical complement pathway starting with a protein called C1, marking them for destruction in a process known as haemolysis.
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Red Blood Cell
Cold Agglutinin
The binding of cold aggluntiinin antibodies triggers the C1 protein to also bind to the red blood cell
This marks the cell for destruction
The red blood cell is destroyed in a process known as haemolysis
Also, cold agglutinin antibodies may bind to red blood cells in small blood vessels, where the temperature is lower than body temperature, and may cause them to clump together (this is called agglutination) and interfere with blood flow through these vessels.
As a rare condition, there have been few studies looking at symptoms. While it’s recognised that people with CAD report a variety of symptoms, there are some common ones that can be caused by haemolysis or agglutination. The symptoms of CAD can vary from person to person and may include fatigue, weakness, shortness of breath, and circulatory symptoms.
Symptoms caused by haemolysis
Haemolysis is the destruction of red blood cells. Red blood cells deliver oxygen to cells throughout your body. Anaemia (low amount of red blood cells) can result when chronic haemolysis destroys more red blood cells than your body can replace. This can lead to some of the common symptoms associated with CAD, such as:
Fatigue
Shortness of Breath
Muscle Weakness
Another consequence of haemolysis is the contents of red blood cells spilling into the blood stream. The haemoglobin from the red blood cells breaks down into a pigment called bilirubin that builds up. High levels of bilirubin may be noticeable as dark urine or jaundice (yellowing of the skin and whites of the eyes).
Haemolysis causes haemoglobin to be released from red blood cells
Haemoglobin broken down
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“I just refuse to be locked in my house, to let this rule my life 100%. It does change your life. But don’t give up. Keep moving forward.”
Brad
Living with CAD
Symptoms caused by agglutination
When cold agglutinins bind red blood cells, the clump of cells and antibodies can slow down or potentially block the flow of blood in small blood vessels. This can be a cause of the circulatory symptoms associated with CAD and for fingers and toes turning a bluish or reddish color.
“My feet would get very sore and very numb and I wore wool socks but that wasn’t enough.”
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Fred
Living with CAD