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Abstract: Exact diagnosis of the subtype has essential therapeutic consequences in autoimmune hemolytic anemia. Cold-antibody types include primary chronic cold agglutinin disease (CAD) and rare cases of cold agglutinin syndrome (CAS) secondary to cancer or acute infection. Primary CAD is a clonal lymphoproliferative disorder. Not all patients require pharmacological therapy, but treatment seems indicated more often than previously thought. Corticosteroids should not be used to treat primary CAD. Half of the patients respond to rituximab monotherapy; median response duration is 11months. The most efficient treatment to date is fludarabine and rituximab in combination, resulting in responses in 75%, complete responses in 20% and median response duration of more than 66months. Toxicity may be a concern, and an individualized approach is discussed. Erythrocyte transfusions can be given provided specific precautions are undertaken. No evidence-based therapy exists in secondary CAS, but optimal treatment of the underlying disorder is essential when feasible. [Copyright &y& Elsevier]

Mycoplasma pneumonia is an atypical pneumonia commonly affecting young patients with generally mild clinical course. We present a case of a 66-year-old female presenting with weight loss, night sweats and low-grade pyrexia. She acquired symptomatic haemolytic anaemia requiring blood transfusion, markedly raised erythrocyte sedimentation rate (ESR) to 114 mm/hr and extensive peri-hilar lymphadenopathy on computed tomography (CT) scan. After excluding malignancy and granulomatous diseases, she made good recovery although a 4 week follow-up CT scan showed persistent but resolving lymphadenopathy. We discuss the considerations for blood transfusion in cold agglutinin disease, and the investigations for immunological manifestations in Mycoplasma pneumonia. [ABSTRACT FROM AUTHOR]