PMID- 29945320
OWN - NLM
STAT- MEDLINE
DCOM- 20190916
LR  - 20190916
IS  - 1433-6510 (Print)
IS  - 1433-6510 (Linking)
VI  - 64
IP  - 6
DP  - 2018 Jun 1
TI  - A Rare Non-Hemolytic Case of Idiopathic Cold Agglutinin Disease.
PG  - 1075-1078
LID - 10.7754/Clin.Lab.2018.180114 [doi]
AB  - BACKGROUND: Cold agglutinin disease is a very rare condition associated with 
      agglutination of erythrocytes in cold environment usually due to IgM type 
      antibodies. Other than hemolytic anemias, it may interfere with routine hemogram 
      tests due to miscalculation of red blood cell count (RBC) and other hemogram 
      parameters calculated with involvement of RBC. Awareness of the condition is 
      important to overcome laboratory errors. METHODS: We studied a peripheral blood 
      smear and repeated the hemogram test at 37 degrees C to establish the diagnosis of cold 
      agglutinin disease. RESULTS: Initial hemogram test results of the fifty-eight 
      year-old man was as follows: RBC: 1.34 M/microL, hemoglobin (Hb): 12.4 g/dL, 
      hematocrit (Htc): 11.8%, mean corpuscular hemoglobin (MCH): 92.4 pg, and mean 
      corpuscular hemoglobin concentration (MCHC): 105 gr/dL. Despite the standard 
      indirect Coombs test being negative, repeated tests at room temperature was 4+. 
      We suspected cold agglutinin disease and repeated the hemogram test using the 
      Bain-Marie method at 37 degrees C and the test results showed RBC: 3.4 M/microL, hemoglobin: 
      12.6 g/dL, hematocrit: 30.2%, MCH: 31.7 pg, and MCHC: 41.8 g/dL. CONCLUSIONS: 
      Inappropriate hemogram results may be a sign of underlying cold agglutinin 
      disease. Hemolytic anemia not always accompanies the disease; however, cold 
      exposure may trigger erythrocyte agglutination in vitro and may cause erratic 
      laboratory results.
FAU - Erkus, Edip
AU  - Erkus E
FAU - Kocak, Mehmet Z
AU  - Kocak MZ
FAU - Aktas, Gulali
AU  - Aktas G
FAU - Ozen, Mehmet
AU  - Ozen M
FAU - Atak, Burcin M
AU  - Atak BM
FAU - Duman, Tuba T
AU  - Duman TT
FAU - Tekce, Buket K
AU  - Tekce BK
FAU - Savli, Haluk
AU  - Savli H
LA  - eng
PT  - Case Reports
PL  - Germany
TA  - Clin Lab
JT  - Clinical laboratory
JID - 9705611
RN  - 0 (Hemoglobins)
RN  - 0 (Immunoglobulin M)
SB  - IM
MH  - Agglutination/immunology
MH  - Anemia, Hemolytic/blood/*diagnosis/immunology
MH  - Anemia, Hemolytic, Autoimmune/blood/*diagnosis/immunology
MH  - *Cold Temperature
MH  - Coombs Test
MH  - Erythrocyte Count
MH  - Erythrocyte Indices
MH  - Erythrocytes/immunology/*metabolism
MH  - Hematologic Tests
MH  - Hemoglobins/metabolism
MH  - Humans
MH  - Immunoglobulin M/blood/immunology
MH  - Male
MH  - Middle Aged
EDAT- 2018/06/27 06:00
MHDA- 2019/09/17 06:00
CRDT- 2018/06/27 06:00
PHST- 2018/06/27 06:00 [entrez]
PHST- 2018/06/27 06:00 [pubmed]
PHST- 2019/09/17 06:00 [medline]
AID - 10.7754/Clin.Lab.2018.180114 [doi]
PST - ppublish
SO  - Clin Lab. 2018 Jun 1;64(6):1075-1078. doi: 10.7754/Clin.Lab.2018.180114.