Cold Agglutinin Syndrome Secondary to <scp><i>Mycoplasma pneumoniae</i></scp> Infection in Adults: Results From a Large French Observational Study (<scp>MyCOLD</scp> Study)

Mycoplasma pneumoniae (MP), primarily a respiratory pathogen, can cause extra-pulmonary manifestations including cold agglutinin syndrome (CAS). We conducted a national, multicenter, observational, ambispective study to describe the characteristics, risk factors, and outcomes of MP-associated CAS. Adult patients hospitalized for a MP-infection with CAS (hemolytic anemia with hemoglobin < 10 g/dL and C3 positive direct anti-globulin test) were included. Recovery was defined as hemoglobin > 10 g/dL off therapy. We also compared MP-infected patients with or without CAS. Sixty patients (51.7% of females; median age of 48.5 years) were included. CAS was diagnosed a median of 10 days after MP-infection symptoms onset. At diagnosis, the median hemoglobin level was 6.9 g/dL, and 71.7% of patients received red blood cell transfusions. Intensive care unit (ICU) admission was required in 45% of patients, and 16.7% experienced a venous thromboembolic event (VTE). Seventeen patients (28.3%) received glucocorticoids alone, while 40 (66.7%) did not receive any specific treatment for CAS. After a median follow-up of 56 (30-83) days, 90% of patients achieved recovery, while 2 patients (3.3%) died from sepsis and pulmonary embolism. Glucocorticoid use did not significantly impact the rate or timing of recovery. Compared with MP-infected patients from the MYCADO cohort study (n = 1267), CAS patients had significantly more VTE (p < 0.0001) and ICU admissions (p = 0.03). MP-associated CAS typically occurs 10 days after the first symptoms of MP infection and is associated with ICU admissions and VTE. Overall, the prognosis of CAS is good, and glucocorticoids do not appear to influence outcomes.

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Journal
American Journal of Hematology
Published
2025-07-19
DOI
https://doi.org/10.1002/ajh.70010
Citations
3
Primary Topic
Blood groups and transfusion
Type
article
Field-Weighted Citation Impact
5.31

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article

Cold Agglutinin Syndrome Secondary to Mycoplasma pneumoniae Infection in Adults: Results From a Large French Observational Study (MyCOLD Study)

Kévin Chevalier, Virginie Baltes, Charlotte Kaeuffer, Étienne Crickx et al.
3 citations
American Journal of Hematology
Blood groups and transfusion
5.31
article

Cold Agglutinin Syndrome Secondary to Mycoplasma pneumoniae Infection in Adults: Results From a Large French Observational Study (MyCOLD Study)

Kévin Chevalier, Virginie Baltes, Charlotte Kaeuffer, Étienne Crickx, Clément Viguier, Simon Rolland, Rishma Amarsy, Hortense Chassepot, Ludovic Lassel, Gaël Galli, K. Blanckaert, Melissa Clément, S Léautez, Romain Palich, Mikaël Ebbo, Matthieu Mahévas, D Chopin, Laurent Gilardin, Louis Terriou, Samuel Deshayes, Marc Michel, Sylvain Audia, V. Salle, V. Pagis, Solal Bellaiche, Thibault Comont, Jessy Cattelan, Bertrand Godeau, Pauline Durand, Moı̈se Coëffier, Simon Valentin, Pierre‐Louis Cariou, Sarra Hamrouni, A Barret, J. Merindol, Michal Holub, Amélie Godot, Bérangère Arnould, David Luque-Paz, Charles Declerck, Jean‐François Viallard, G. Le Moal, Anne‐Lise Lecapitaine, Natacha Mrozek, Jean‐Emmanuel Kahn, Thomas Perpoint, Martin Martinot, Soline De Monteynard
article en
3 citations

Abstract

Mycoplasma pneumoniae (MP), primarily a respiratory pathogen, can cause extra-pulmonary manifestations including cold agglutinin syndrome (CAS). We conducted a national, multicenter, observational, ambispective study to describe the characteristics, risk factors, and outcomes of MP-associated CAS. Adult patients hospitalized for a MP-infection with CAS (hemolytic anemia with hemoglobin < 10 g/dL and C3 positive direct anti-globulin test) were included. Recovery was defined as hemoglobin > 10 g/dL off therapy. We also compared MP-infected patients with or without CAS. Sixty patients (51.7% of females; median age of 48.5 years) were included. CAS was diagnosed a median of 10 days after MP-infection symptoms onset. At diagnosis, the median hemoglobin level was 6.9 g/dL, and 71.7% of patients received red blood cell transfusions. Intensive care unit (ICU) admission was required in 45% of patients, and 16.7% experienced a venous thromboembolic event (VTE). Seventeen patients (28.3%) received glucocorticoids alone, while 40 (66.7%) did not receive any specific treatment for CAS. After a median follow-up of 56 (30-83) days, 90% of patients achieved recovery, while 2 patients (3.3%) died from sepsis and pulmonary embolism. Glucocorticoid use did not significantly impact the rate or timing of recovery. Compared with MP-infected patients from the MYCADO cohort study (n = 1267), CAS patients had significantly more VTE (p < 0.0001) and ICU admissions (p = 0.03). MP-associated CAS typically occurs 10 days after the first symptoms of MP infection and is associated with ICU admissions and VTE. Overall, the prognosis of CAS is good, and glucocorticoids do not appear to influence outcomes.

American Journal of HematologyVol. 100(9)
Apple (Israel) (IL), Université Toulouse III - Paul Sabatier (FR), Inserm (FR), Université Fédérale de Toulouse Midi-Pyrénées (FR), Université Paris-Est Créteil (FR), Université de Lille (FR), Bangour Village Hospital (GB), Centre Hospitalier Universitaire de Bordeaux (FR), Centre Hospitalier Universitaire de Lille (FR), Centre Hospitalier Universitaire de Nice (FR), Université de Poitiers (FR), Sorbonne Université (FR), Assistance Publique Hôpitaux de Marseille (FR), Université Sorbonne Paris Nord (FR), Hopitaux Civils de Colmar (FR), Centre Hospitalier Universitaire Amiens-Picardie (FR), Assistance Publique – Hôpitaux de Paris (FR), Center for Infection and Immunity of Lille (FR), Institut universitaire du cancer de Toulouse Oncopole (FR), Hospices Civils de Lyon (FR), Hôpital Saint-Antoine (FR), University of Clermont Auvergne (FR), Centre hospitalier de Rouffach (FR), Centre Hospitalier De Pau (FR), Centre Hospitalier Universitaire de Poitiers (FR), Délégation Régionale Provence-Alpes-Côte d’Azur et Corse (FR), Hôpital Fernand-Widal (FR), Centre Hospitalier Compiègne-Noyon (FR), Imagerie Adaptative Diagnostique et Interventionnelle (FR), Centre Hospitalier de Mulhouse (FR), Hôpital Lariboisière (FR), Hôpital Cardiologique du Haut-Lévêque (FR), Melun Hospital (FR), Hôpital Pontchaillou (FR), Centre Hospitalier Universitaire de Clermont-Ferrand (FR), Hôpital Avicenne (FR), Hôpitaux Universitaires Henri-Mondor (FR), Centre Hospitalier Régional Universitaire de Brest (FR), Hôpital Ambroise-Paré (FR), Institut Pierre Louis d‘Épidémiologie et de Santé Publique (FR), Centre Hospitalier d'Albi (FR), Maison des Sciences sociales et des Humanités de Dijon (FR), Centre Hospitalier Départemental Vendée (FR), Hôpital Jean-Verdier (FR), Centre Hospitalier Universitaire de Rennes (FR), Bicêtre Hospital (FR), Association pour l'Utilisation du Rein Artificiel (FR), Hôpital Tenon (FR), Université d'Angers (FR), Université de Rouen Normandie (FR), Université de Lorraine (FR), Université de Caen Normandie (FR)
Université de Lorraine, Université de Lille, Institut National de la Santé et de la Recherche Médicale, Assistance Publique - Hôpitaux de Paris, Université de Toulouse, Sorbonne Université, Centre Hospitalier Universitaire de Poitiers
Good health and well-being
Openalex Percentile: Top 4%
Blood groups and transfusion
5.31
DOIOpen Access PDFOpenAlex
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