How does a cold agglutinin affect CBC results?
While RBC agglutination causes clinical symptoms of hemolytic anemia, agglutination caused by cold agglutinin is a notorious pre-analytical and analytical factor that leads to spurious automated complete blood count (CBC) results [2].
What CBC parameters are affected by cold agglutinin?
If the cold agglutinin is operative at room temperature, then a falsely high mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) with a low RBC count are obtained due to agglutination of RBCs in the cold automated counter.
What does a positive cold agglutinin test mean?
A positive titer may mean that the person tested has cold agglutinin disease. Cold agglutinin disease may be primary or secondary, induced by some other disease or condition such as: Mycoplasma pneumoniae infections—up to 75% of those affected will have increased cold agglutinins.
How are cold agglutinins diagnosed?
In most cases, the diagnosis is based on evidence of hemolytic anemia (from symptoms and/or blood tests). A person may also be physically examined for spleen or liver enlargement. An antiglobulin test (called the Coombs test) may be performed to determine the presence of a specific type of antibody .
What is a high cold agglutinin titer?
High values High titers of cold agglutinins may be caused by infections, such as pneumonia caused by mycoplasma, mononucleosis, hepatitis C, or other viral infections. High titers of cold agglutinins can cause symptoms when a person is exposed to cold temperatures.
What is a normal cold agglutinin titer?
Reference Range: Titer: <1:64. Patients with cold agglutinin syndrome usually exhibit a titer value greater that 1:512, with rare cases reported as low as 1:64. Normal individuals often have low levels of cold aggulitinins.
What is cold agglutinin in blood?
Cold agglutinins – Cold agglutinins are antibodies that recognize antigens on red blood cells (RBCs) at temperatures below normal core body temperature. They can cause agglutination of the RBCs (picture 1) and extravascular hemolysis, resulting in anemia, typically without hemoglobinuria.
What is low MCHC?
A low mean corpuscular hemoglobin concentration (MCHC) shows that someone’s red blood cells do not have enough hemoglobin. Hemoglobin is an iron-rich protein, and a lack of it may indicate anemia. Hemoglobin is responsible for the red color in blood and for circulating oxygen around the body.
What are normal results on a cold agglutinins test?
The result of a cold agglutinin test is typically reported as a titer, such as 1:64 or 1:512 . A higher number means that there are more autoantibodies present. A positive titer may mean that the person tested has cold agglutinin disease.
What is the prognosis of cold agglutinin disease?
The outlook for people with secondary cold agglutinin disease caused by bacterial or viral infections is excellent prognosis and cold agglutinin disease symptoms usually go away within 6 months after the infection has resolved.
What are rare causes of cold agglutinin disease?
Cold agglutinin disease (CAD) is a rare type of autoimmune hemolytic anemia-an anemia that develops when your immune system attacks and destroys your red blood cells. The most common cause of AIHA is due to a warm autoantibody .
How do I treat cold agglutinin hemolytic anemia?
Diet and activity . Patients with cold agglutinin disease should include good sources of folic acid, such as fresh fruits and vegetables , in their diet. Activities for these individuals should be less strenuous than those for healthy people, particularly for patients with anemia.