Symptoms of Cold Agglutinin Disease

When your body’s immune system takes aim at its own red blood cells, as it does with a rare form of anemia called cold agglutinin disease (CAD), the side effects can range from mild to severe. They also can come on suddenly or over time.

Mild Symptoms

If your symptoms don’t cause much trouble, you may not even know you have CAD unless your doctor does a blood test that shows a certain type of anemia. Less serious signs of CAD can include:

  • Fatigue
  • Dizziness
  • Cold hands and feet
  • Pale skin
  • Headaches
  • Weight loss
  • Joint pain
  • Trouble concentrating
  • Irritability
  • Ringing in your ears
  • Spots in your vision
  • Women may not have periods
  • Severe Symptoms

More serious symptoms can happen when CAD is linked to another condition related to your immune system or to a serious illness, like cancer or an infection. Those can include:

  • Jaundice (yellowing of your skin and the white part of your eyes)
  • Chest pain
  • Heart problems, including an irregular heartbeat, a heart murmur, an enlarged heart, or heart failure
  • Fever
  • Fainting
  • Vomiting and diarrhea
  • Dark urine
  • Pain in your back or legs
  • Circulation problems, including pain and bluish coloring of your hands and feet and Raynaud’s phenomenon, a rare disorder of blood vessels in your fingers and toes
  • Trouble breathing
  • Swollen lymph nodes


  2. National Center for Advancing Translational Services: “Cold Agglutinin Disease.”
  3. “Autoimmune Hemolytic Anemia.”
  4. “Anemia, Hemolytic, Cold Antibody.”
  5. “Cold Agglutinins”
  6. European Hematology Association: “The Occurrence and Survival of Cold Agglutinin Disease in Denmark.”

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