Open AccessResolution of serologic problems due to cold agglutinin mediated autoimmune hemolytic anemia and its transfusion decision
Author(s) -
Ying Qiming,
Lv Dingfeng,
Fu Xiaomei,
Shi Shuanglu,
Chen Luyan,
He Yiwen,
Yang Jing,
Yang Shujun,
Mu Qitian
Publication year - 2021
Publication title -
journal of clinical laboratory analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.536
H-Index - 50
eISSN - 1098-2825
pISSN - 0887-8013
DOI - 10.1002/jcla.23894
Subject(s) - autoimmune hemolytic anemia , cold agglutinin , cold agglutinin disease , hemolysis , autoantibody , medicine , immunology , serology , hemolytic anemia , agglutinin , haptoglobin , antibody , anemia , coombs test , blood transfusion , lectin
Background Autoimmune hemolytic anemia (AIHA) is a rare disease characterized by hemolysis caused by autoantibodies against erythrocyte surface antigen. These antibodies can be classified as warm, cold, or mixed types. Methods We report two cases of cold agglutinin disease (CAD), which were eventually diagnosed owing to blood group discrepancy. Resolution was achieved after washing the red blood cells (RBCs) with warm saline and absorbing the autoantibodies at 4°C with the washed RBCs. We also assessed the patient's condition and discussed the strategy of blood transfusion. Results The first case occurred after postoperative chemotherapy for rectal cancer, and the other manifested with anemia from the outset. Direct antiglobulin tests were positive and revealed autoantibodies against C3d only. Cold agglutinin titration was performed, and the titers of both were 1:1024. Eventually, the patient's condition stabilized without blood transfusion. Conclusion The serological discrepancies observed in the blood transfusion department can successfully guide blood transfusion decisions in cases of CAD.