this has been requested as a change many times before. have never known what to do with this card. will need some help
UpToDate cites “Berentesen et al., 2015” in their section on “Cold agglutinin disease::Pathogenesis::Mechanism of hemolysis” to say “Hemolysis in CAD is primarily extravascular and mediated by complement”. Just another addition to the confusion for you
amboss table lists as “Mostly extravascular hemolysis, however, intravascular hemolysis can occur when severe” - lower in another section mentions - “Stable disease: extravascular hemolysis of complement-coated RBCs by the mononuclear phagocyte system
Acute exacerbations: Intravascular hemolysis can occur, mediated through the complement system, which is activated by IgM antibodies bound to RBCs.”
my vote is put “intravascular hemolysis can occur in severe cases through complement-activation on RBCs bound by IgM antibodies” in the extras and leave text unchanged from its current state, “usually” is the give away too and amboss explanations support
That sounds like a plan ^^ agreed.