tetano
Editor, Senior Moderator
BMJ Case Rep
. 2022 Apr 29;15(4):e242937.
doi: 10.1136/bcr-2021-242937.
Cold agglutinin disease secondary to severe SARS-CoV-2 treated with eculizumab
Yachar Dawudi[SUP] 1 [/SUP], Laura Federici[SUP] 2 [/SUP], Jérôme Debus[SUP] 3 [/SUP], Noémie Zucman[SUP] 1 [/SUP]
Affiliations
Abstract
Impaired immune response with uncontrolled inflammation and various immunological disorders have been reported during SARS-CoV-2 infection. Here, we report a case of cold agglutinin disease occurring during a severe coronavirus disease 2019 (COVID-19) in a French intensive care unit. A patient was presented with acute respiratory distress syndrome, acute renal failure and haemolytic anaemia. Direct antiglobulin test was positive with a cold agglutinin titre of 1/512. No other cause than COVID-19 explained the occurrence of cold agglutinin disease; however, causality could not be formally established. Persistent anaemia despite transfusion therapy and the short-term life-threatening, prompted the infusion of a monoclonal anti-C5 antibody (eculizumab). Eculizumab therapy quasi-fully resolved haemolysis within a few days, but ultimately the patient died from his severe COVID-19 infection. Data regarding the specific treatment of cold agglutinin disease during COVID-19 are rare. Although additional studies are warranted, eculizumab may be considered in critical situations.
Keywords: Adult intensive care; COVID-19; Haematology (drugs and medicines); Infectious diseases.
. 2022 Apr 29;15(4):e242937.
doi: 10.1136/bcr-2021-242937.
Cold agglutinin disease secondary to severe SARS-CoV-2 treated with eculizumab
Yachar Dawudi[SUP] 1 [/SUP], Laura Federici[SUP] 2 [/SUP], Jérôme Debus[SUP] 3 [/SUP], Noémie Zucman[SUP] 1 [/SUP]
Affiliations
- PMID: 35487646
- DOI: 10.1136/bcr-2021-242937
Abstract
Impaired immune response with uncontrolled inflammation and various immunological disorders have been reported during SARS-CoV-2 infection. Here, we report a case of cold agglutinin disease occurring during a severe coronavirus disease 2019 (COVID-19) in a French intensive care unit. A patient was presented with acute respiratory distress syndrome, acute renal failure and haemolytic anaemia. Direct antiglobulin test was positive with a cold agglutinin titre of 1/512. No other cause than COVID-19 explained the occurrence of cold agglutinin disease; however, causality could not be formally established. Persistent anaemia despite transfusion therapy and the short-term life-threatening, prompted the infusion of a monoclonal anti-C5 antibody (eculizumab). Eculizumab therapy quasi-fully resolved haemolysis within a few days, but ultimately the patient died from his severe COVID-19 infection. Data regarding the specific treatment of cold agglutinin disease during COVID-19 are rare. Although additional studies are warranted, eculizumab may be considered in critical situations.
Keywords: Adult intensive care; COVID-19; Haematology (drugs and medicines); Infectious diseases.