Severe Anemia Due to Cold Agglutinin Syndrome in a COVID-19 Patient with IgM Monoclonal Gammopathy of Undetermined Significance Successfully Treated with Corticosteroids

Yutaka Tsukamoto; Masataka Umeda; Yuko Muto; Takashi Sugimoto; Momoko Yamauchi; Koji Ando; Koya Ariyoshi

doi:10.2169/internalmedicine.8647-21

This article has now been updated. Please use the final version.

Severe Anemia Due to Cold Agglutinin Syndrome in a COVID-19 Patient with IgM Monoclonal Gammopathy of Undetermined Significance Successfully Treated with Corticosteroids

Yutaka Tsukamoto, Masataka Umeda, Yuko Muto, Takashi Sugimoto, Momoko Yamauchi, Koji Ando, Koya Ariyoshi

Author information

Yutaka Tsukamoto
Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Japan
Masataka Umeda
Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
Department of General Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan
Yuko Muto
Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Japan
Takashi Sugimoto
Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Japan
Momoko Yamauchi
Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Japan
Koji Ando
Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Japan
Koya Ariyoshi
Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Japan

Keywords: COVID-19, cold agglutinin syndrome, autoimmune hemolytic anemia, monoclonal gammopathy of undetermined significance, corticosteroid

JOURNAL OPEN ACCESS Advance online publication

Article ID: 8647-21

DOI https://doi.org/10.2169/internalmedicine.8647-21

The final version of this article is now available: Vol. 61 (2022), No. 11 pp. 1789-1793

Details

Abstract

Secondary cold agglutinin syndrome (CAS) is autoimmune hemolytic anemia secondary to infections and lymphoid disorder. We here report the first Asian case of CAS secondary to novel coronavirus disease 2019 (COVID-19). A 72-year-old Japanese woman presented with a 2-week history of dyspnea and cough, and laboratory data revealed severe hemolytic anemia with a hemoglobin level of 4.7 g/dL. She was diagnosed with COVID-19, CAS, and monoclonal gammopathy of undetermined significance (MGUS). The anemia responded to corticosteroids administered for COVID-19 and required maintenance therapy. Although corticosteroids are not a standard therapy for CAS, they might be effective for CAS secondary to COVID-19 complicated with MGUS.

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