Complement-mediated hemolysis persists year round in patients with cold agglutinin disease
Autor: | Jaime Morales Arias, Parija Patel, Alexander Röth, Catherine Broome, Jun Su, Heidi Reichert, Jon P. Fryzek, Xiaohui Jiang |
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Rok vydání: | 2021 |
Předmět: |
Male
medicine.medical_specialty Bilirubin Cold agglutinin disease Anemia Immunology Medizin Gastroenterology Hemolysis chemistry.chemical_compound Internal medicine Lactate dehydrogenase Thromboembolism medicine Immunology and Allergy Humans biology L-Lactate Dehydrogenase business.industry Hematology Complement System Proteins medicine.disease chemistry Immunoglobulin M biology.protein Female Hemoglobin Anemia Hemolytic Autoimmune Autoimmune hemolytic anemia business |
Zdroj: | TransfusionREFERENCES. 62(1) |
ISSN: | 1537-2995 |
Popis: | Background: Cold agglutinin disease (CAD) is a rare autoimmune hemolytic anemia mediated by immunoglobulin M autoantibodies that bind to the “I” antigen on erythrocytes. IgM binding results in either agglutination at ≤37°C, activation of the classical complement pathway, or both. Patients with CAD can have transient agglutination-mediated circulatory symptoms triggered by exposure to cold conditions. Separately, patients with CAD can experience complement-mediated symptoms such as anemia, hemolysis, and fatigue, but the effect of the season on these complement-mediated manifestations of CAD and clinical outcomes is not well understood. Methods: Using data from the Optum® de-identified Electronic Health Record dataset, we compared hemoglobin, markers of hemolysis (bilirubin and lactate dehydrogenase [LDH]), and healthcare resource utilization (HRU) between seasons for 594 patients (62% female; 66% aged ≥65 years) with CAD (defined as having CAD-related terms in their clinical notes on ≥3 separate occasions between December 2008 and May 2016). Laboratory parameters and HRU were compared between seasons using multivariate regression models. Results: Estimated median hemoglobin (9.87 g/dL in summer and 9.86 g/dL in winter; P = 0.944) and bilirubin (1.04 mg/dL in summer and 1.09 mg/dL in winter; P = 0.257) were similar in winter versus summer. While LDH was statistically significantly higher in winter compared with summer (P < 0.001), the estimated median value was above normal for both seasons (309 U/L in summer and 367 U/L in winter). HRU measures and transfusion and thromboembolism rates were similar across seasons. Conclusions: Patients with CAD had evidence of persistent chronic hemolysis, HRU, and thromboembolism risk year round. |
Databáze: | OpenAIRE |
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