How do I diagnose Cold Agglutinin Disease?
CAD is a rare and serious autoimmune hemolytic condition with systemic acute and chronic consequences.1-3 Because of the risks patients with CAD face, it's important to understand how to accurately diagnose CAD.
Diagnosis of CAD requires both a positive direct antiglobulin test (DAT) and detectable presence of IgM autoantibodies.4,5
- If CAD is suspected based on initial anemia presentation, first confirm hemolysis is present via bilirubin and LDH blood tests
- Then, confirm polyspecific DAT and monospecific DAT for C3d
- Perform a full clinical assessment to rule out possible alternative causes for hemolytic anemia and positive DAT
- Next, confirm that Cold Agglutinin Titer is above or equal to 1:64
- Evaluate with further clinical and serological assessments to confirm diagnosis of CAD
- To distinguish between CAD and CAS, confirm presence of infection or overt malignancy
- If no infection or overt malignancy, diagnose with CAD
- If overt malignancy is present, diagnose with CAS
- If febrile infection is present, determine if onset of anemia occurred before infection. If so, then diagnose with CAD; if not, diagnose with CAS
Find out more about CAD diagnosis here.