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Nikousefat Z, Javdani M, Hashemnia M, et al. Cold Agglutinin Disease; A Laboratory Challenge. Iran Red Crescent Med J. 2015;17(10):e18954doi: 10.5812/ircmj.18954.
Nikousefat, Z., Javdani, M., Hashemnia, M., Haratyan, A., & Jalili, A. (2015). Cold Agglutinin Disease; A Laboratory Challenge. Iranian Red Crescent medical journal, 17(10), e18954. https://doi.org/10.5812/ircmj.18954
Nikousefat, Zahra, et al. "Cold Agglutinin Disease; A Laboratory Challenge." Iranian Red Crescent medical journal vol. 17,10 (2015): e18954. doi: https://doi.org/10.5812/ircmj.18954
Nikousefat Z, Javdani M, Hashemnia M, Haratyan A, Jalili A. Cold Agglutinin Disease; A Laboratory Challenge. Iran Red Crescent Med J. 2015 Oct 17;17(10):e18954. doi: 10.5812/ircmj.18954. eCollection 2015 Oct. PMID: 26566452; PMCID: PMC4636857.
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Iran Red Crescent Med J. 2015 Oct 17;17(10):e18954. doi: 10.5812/ircmj.18954. eCollection 2015 Oct.

Cold Agglutinin Disease; A Laboratory Challenge.

Iranian Red Crescent medical journal

Zahra Nikousefat, Moosa Javdani, Mohammad Hashemnia, Abbas Haratyan, Ali Jalili

Affiliations

  1. Department of Clinical Sciences, Veterinary Faculty, Razi University, Kermanshah, IR Iran.
  2. Department of Veterinary Surgery and Radiology, Veterinary Faculty, Shahrekord University, Shahrekord, IR Iran.
  3. Department of Pathobiology, Veterinary Faculty, Razi University, Kermanshah, IR Iran.
  4. Department of Pathology, Sajad Hospital, Kermanshah, IR Iran.

PMID: 26566452 PMCID: PMC4636857 DOI: 10.5812/ircmj.18954

Abstract

INTRODUCTION: Autoimmune haemolytic anemia (AIHA) is a complex process characterized by an immune reaction against red blood cell self-antigens. The analysis of specimens, drawn from patients with cold auto-immune hemolytic anemia is a difficult problem for automated hematology analyzer. This paper was written to alert technologists and pathologists to the presence of cold agglutinins and its effect on laboratory tests.

CASE PRESENTATION: A 72-year-old female presented to the Shafa laboratory for hematology profile evaluation. CBC indices showed invalid findings with the Sysmex automated hematology analyzer. Checking the laboratory process showed precipitation residue sticking to the sides of the tube. After warming the tubes, results become valid and the problem attributed to cold agglutinin disease. In this situation, aggregation of RBCs, which occurs at t < 30°C, causes invalid findings meanwhile working with automated hematology analyzer.

CONCLUSIONS: Knowledge of this phenomenon can help prevent wasting too much time and make an early and accurate diagnosis.

Keywords: Cold Agglutinin Disease; Hemolytic Anemia; Sysmex Autoanalyzer

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