Aortic arch aneurysm in a patient with cold agglutinin disease: Figure 1:

Cold agglutinin disease is a form of antiglobulin-positive haemolysis caused by circulating autoantibodies that are present in most humans and become active at temperatures below a threshold value [1]. Cardiac surgery requiring systemic hypothermia and cold cardioplegia carries a significant risk of agglutination of red blood cells or haemolysis in patients with cold agglutinin disease. We herein report this case to discuss treatment options with the readers. A 70-year old man presented with hoarseness a year ago, and saw an otolaryngologist 2 months ago. Computed tomography showed a thoracic aortic aneurysm in the distal arch (Fig. 1). Preoperative testing demonstrated elevated cold agglutinins with a titre of 1:128; the red blood cells coagulated in the patient's serum at 27°C. Preoperative computed tomography. Conflict of interest: none declared.