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Document Details :
Title: Een ongewone oorzaak van abdominale pijn
Author(s): MONBALLYU P, TEUWEN J
Journal: Tijdschrift voor Geneeskunde
Volume: 66 Issue: 7 Date: 2010
An unusual cause of abdominal pain
A 76-year-old man presents with abdominal pain, which has risen as he worked in his garden in the freezing cold. He also reports that his urine is brown- colored. Physical examination reveals a painfull abdomen. Laboratory results indicate an auto-immune haemolytic anemia. There is a high titer of cold agglutinins. The diagnosis of a cold agglutination syndrome is made. Investigation of a bone marrow sample reveals Waldenström disease. A treatment with chlorambucil and methylprednisolone is started.
Cold agglutination disease is characterized by acute episodes of intravascular hemolysis in association with exposure to cold. One should always keep in mind an underlying disorder (infection or hematologic malignancy). Treatment choice depends on the underlying disease.
In case of recurrent abdominal pain, non-abdominal causes should always be considered.