Cold agglutinin disease revealing mediastinal seminoma

Sir, Cold agglutinin disease (CAD) is an autoimmune haemolytic anaemia in which cold-reactive auto-antibodies bind to erythrocyte carbohydrate antigens, causing hemagglutination and complement-mediated haemolysis.1–4 It is associated with various conditions, including infections ( Mycoplasma pneumoniae , hepatitis C), autoimmune diseases (especially systemic lupus erythematosus) and lymphoproliferative disorders (mainly lymphoma.1–8 However, it has rarely been described in patients with malignant solid tumours. We report a case of interest, where a patient developed CAD-associated haemolytic anaemia related to mediastinal seminoma, with a favourable outcome after chemotherapy. A 61-year-old man presented in December 2001 with a 1-month history of asthenia. On admission, he was pale, but general physical examination was otherwise normal, and in …