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Living with Cold agglutinin disease

A rare blood condition where the immune system destroys red blood cells, which can cause tiredness and pale skin.

Understanding Cold agglutinin disease

Cold agglutinin disease is a rare autoimmune condition in which the immune system mistakenly destroys the body's own red blood cells.

In the cold, the immune system makes antibodies that clump red blood cells together. The cells are then destroyed too early, which leads to anemia (too few healthy red blood cells). It usually starts in adulthood. It can have no known cause (primary) or follow another condition such as an infection, an autoimmune disease or certain cancers (secondary).

Signs & symptoms

Symptoms vary from person to person. GARD lists these among the most common:

  • Tiredness (fatigue)
  • Muscle weakness
  • Pale skin (pallor)
  • Joint pain
  • Anemia from red blood cell breakdown (hemolytic anemia)

Not everyone has every symptom. GARD's list comes from the Human Phenotype Ontology.

Diagnosis

  1. Talk with your doctor

    Share the symptoms you've noticed, when they started and your family health history. Notes and photos can help.

  2. See a specialist

    Specialists who may be involved include blood and bone marrow specialists.

  3. Ask which tests can help

    Your care team will decide which exams and tests can confirm the diagnosis.

  4. Connect with expert centers

    Autoimmune Association, Cold Agglutinin Disease Foundation and Global Autoimmune Institute may keep lists of experts for this condition.

Care & treatment

Care team
Blood and bone marrow specialists (hematologists)
Expert care
Expert lists: Autoimmune Association, Cold Agglutinin Disease Foundation, Global Autoimmune Institute
Treatment
GARD doesn't list specific treatments for this condition. Your care team will tailor care to your symptoms.
Research
Clinical trials and observational studies may be options. See the research section below.

General information, not medical advice. Your care team makes the decisions.

Everyday life

Living with a rare condition is easier with support.

  • Connect with Autoimmune Association and other patient organizations
  • Keep notes on symptoms, changes and questions for appointments
  • Ask about patient registries that help research
  • Look into financial aid and travel resources for care visits
Bring these questions to your next doctor visit
Is my condition primary or secondary to another illness?
How do cold temperatures affect my symptoms?
Which specialist should manage my anemia?

Quick facts

Symptoms usually startAdult

The cause can be unknown (primary) or an underlying condition such as an infection, another autoimmune disease or certain cancers (secondary).

Blood

Also known as: cad; cas; chronic cold agglutinin disease; cold agglutinin syndrome; cold antibody disease

Patient organizations

Source: NIH GARD · Cold agglutinin diseaseGARD ID 6130 · GARD page updated September 2026 · Plain-language summary by Know Rare; editorial review pending. General information, not medical advice.

You are more than your diagnosis

Perspectives from people navigating life with Cold agglutinin disease.

Explore the Cold agglutinin disease blog

Explore research for Cold agglutinin disease

Explore actively recruiting Cold agglutinin disease studies with HealthSpark.

HealthSpark

Find actively recruiting studies for Cold agglutinin disease with HealthSpark. Share your city to explore research near you.

  • Recruiting studies from ClinicalTrials.gov
  • Share your city to look for research near you
  • Eligibility is confirmed by the study team

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Powered by HealthSpark, our AI chat helper · Study information from ClinicalTrials.gov · Eligibility is confirmed by the study team.

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