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Primary cold agglutinin disease is characterized by its ability to present as either a chronic or transient condition. This aspect highlights the variability in how the disease can manifest among individuals. Some patients may experience persistent symptoms over a longer duration, while others may have episodes that resolve relatively quickly. The nature of the disease is linked to the presence of cold agglutinins, which are antibodies that cause red blood cells to clump together at lower temperatures, leading to hemolytic anemia.

This condition does not exclusively occur in children, contradicting the implication of the second choice; while it can affect children, it is more commonly seen in adults, typically over the age of 50. Moreover, it is not characterized solely by isolated incidents without complications, as patients may experience significant clinical issues due to the hemolysis that can lead to a range of symptoms. Lastly, while infections can trigger cold agglutinin disease, particularly in cases driven by viral infections like Mycoplasma pneumoniae, the disease is not exclusively related to infections, indicating a broader range of potential triggers and contexts. Thus, the chronic or transient nature of the disease is a defining characteristic that supports the definitive answer.