People with Waldenstrom’s macroglobulinaemia produce abnormal levels of a protein called IgM. IgM can cause the red blood cells to stick together in the coolest parts of the body, like the hands and feet, tip of the nose or the ear lobes. These cause ‘clumps’ of red blood cells, which break down. This can cause anaemia, because your body doesn’t have enough red blood cells.
The antibodies that clump the red blood cells are triggered when your body temperature drops below normal, hence ‘cold’ agglutinin disease.
What are the symptoms?
Fatigue
Painful fingers and toes when exposed to the cold
Shortness of breath
Dizziness
Dark urine
Pale/yellow skin (jaundice)
Chest pains or irregular heartbeat
How is it diagnosed?
CAD is diagnosed through a blood test. Your doctor will look for a lower number of red blood cells that will indicate you have anaemia, as well as seeing if your red blood cells are sticking together. If the tests show signs of CAD and you’re describing CAD symptoms, your doctor can do another blood test called a direct antiglobulin test – or Coombs test – that will show if the abnormal antibodies are sticking onto your red blood cells.
How can it be treated?
Your doctor will recommend you do things to keep your body temperature up to stop the antibodies attacking your red blood cells. This could include:
Wearing more clothes, both in summer and winter
Avoiding air conditioning where possible
Staying away from cold food or drink
If you doctors decides that you need treatment, this may include blood transfusions and treatment such as rituximab or combination of drugs that treat WM. Alternatively, you may be eligible for treatment on clinical trials.
The decision to use drugs to treat CAD depends on your individual circumstances, like the severity of your CAD, any previous treatment you’ve had for your WM and your general health.
