THE chilly autumn weather can be uncomfortable for most people – triggering the common cold or shivers at night.
However, for one elderly woman, cold temperatures spark something much scarier.
A 70-year-old patient from New York, who has not been named, went to her doctor after she developed an unusual mottled purple rash all over her body.
It was described by the US National Library of Medicine as a “netlike pattern of reddish-blue skin discolouration.”
As well as experiencing some dizziness, she told medics that two weeks earlier, she had developed flu-like symptoms.
At first, doctors suggested that her giant rash appeared to be due to a skin problem called livedo reticularis, which is thought to be caused by spastic blood vessels or abnormal circulation just beneath the skin.
However, according to the report published in the New England Journal of Medicine, doctors from the Bassett Medical Centre in New York decided to examine the woman further and took more blood samples.
These tests revealed that the patient’s red blood cells, which carry oxygen and give blood its red colour, had spontaneously stuck together.
And medics were stunned to discover that the pensioner’s blood was almost clear with big crimson clumps floating through it, rather than a solid red colour.
Docs confirmed that she actually had a rare condition called cold agglutinin disease, where the immune system starts destroying red blood cells.
This is triggered by lower temperatures as the antibodies bond with red blood cells instead of seeking out and destroying viruses and bacteria.
The captured cells pile up in chunky clumps, a process known as agglutination, which eventually kills the cells and leaves people deprived of much-needed blood oxygen.
Experts revealed that both the patient’s recent infection and the cold New York weather — which was around minus 9 degrees Celsius when she developed her symptoms — may have exacerbated her condition.
What is cold agglutinin disease?
Cold agglutinin disease causes the immune system to mistakenly attack its own red blood cells.
It is estimated to affect one in 50,000 people and it is normally caused by an underlying condition such as an infection, another autoimmune disease, or certain cancers.
Doctors are unsure as to why it sometimes occurs in patients who show no other symptoms.
However, cold temperatures can send the immune system into overdrive, which doctors say may escalate the condition.
When affected people’s blood is exposed to cold temperatures, certain proteins that normally attack bacteria attach themselves to red blood cells and bind them together into clumps.
This eventually causes red blood cells to be destroyed and leave people deprived of oxygen, leading to anaemia.
Anaemia is a condition in which you lack enough healthy red blood cells to carry adequate oxygen to your body’s tissues.
The number of symptoms and severity of symptoms may depend on how severe the anaemia is. They may include:
- Cold hands and feet
- Pale skin
- Dark urine
- Chest pain
- Pain in the back or legs
- Vomiting or diarrhea
- Heart problems such as an irregular heartbeat (arrhythmia), a heart murmur, an enlarged heart, or heart failure
Many people with CAD also experience pain and bluish colouring of the hands and feet.
These symptoms result from slow or poor circulation and can range from mild to disabling.
The woman was treated with blood transfusions and a cancer medication known as rituximab.
And after a week of treatment, her ratio of red blood cells to total blood volume more than doubled, a sign that her anemia had disappeared, and her dizziness subsided.
Despite this, her mottled rash still remained when she was discharged from the hospital.
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Normally cold agglutinin disease is caused by an underlying condition such as an infection, another autoimmune disease, or certain cancers.
Doctors don’t know why it sometimes occurs in patients who show no other symptoms.
But cold temperatures can send the immune system into overdrive, which doctors say may spur on the condition.
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