Cold Agglutinin Disease in a Patient of Pulmonary Tuberculosis.

We report a case of secondary cold agglutinin disease (CAD) due to pulmonary tuberculosis in a 68-year male patient who presented with acrocyanosis involving both upper limbs and greater portion of lower limbs. Direct Coombs' test was positive with mild anemia and the cold agglutinin titer was high. Sputum showed numerous acid fast bacilli per high power field. The patient was given standard anti-tuberculous treatment (ATT) and his symptoms gradually improved. After nine months of ATT, his haemoglobin improved, acrocyanosis resolved completely and cold agglutinin titer decreased in level.