Department of clinical chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia.
Biochem Med (Zagreb). 2018 Oct 15;28(3):031001. doi: 10.11613/BM.2018.031001.
The presence of cold agglutinins (CAs) in samples intended for complete blood count (CBC) using automated haematology analysers might cause serious preanalytical errors. In this report we describe the case of a 90-year old female patient admitted to the Emergency department following trauma injuries. A blood testing on admission revealed surprisingly low red blood cell count (0.99 x 10/L), low haematocrit (0.102 L/L) which did not correlate with haemoglobin concentration (100 g/L), and high erythrocytes indices (mean corpuscular haemoglobin, 101 pg; mean corpuscular haemoglobin concentration, 980 g/L). In the second sample, after repeated collection, almost equal results were observed. Blood smear examination under the microscope revealed clusters of erythrocytes. Cold agglutinins presence was suspected and, in order to get valid results, sample was warmed to 37 °C. Correction of CBC was observed. Furthermore, we performed some additional analysis to confirm the presence of CAs in this patient. The aim of this report was to present the laboratory findings in a case of CAs and propose a laboratory procedure for whole blood samples with suspected CAs.
冷自身抗体（CA）在使用自动化血液分析仪进行全血细胞计数（CBC）的样本中存在，可能导致严重的分析前误差。在本报告中，我们描述了一位 90 岁女性患者在创伤后入住急诊科的情况。入院时的血液检测显示红细胞计数（0.99 x 10/L）、血细胞比容（0.102 L/L）明显偏低，且与血红蛋白浓度（100 g/L）不成比例，红细胞指数（平均红细胞血红蛋白，101 pg；平均红细胞血红蛋白浓度，980 g/L）偏高。在第二份样本中，经过多次采集，观察到几乎相同的结果。显微镜下的血涂片检查显示红细胞聚集。怀疑存在冷自身抗体，为了获得有效的结果，将样本加热至 37°C。CBC 得到纠正。此外，我们还进行了一些额外的分析，以确认该患者存在 CAs。本报告的目的是介绍一例 CAs 的实验室发现，并提出一个针对疑似 CAs 的全血样本的实验室程序。
