Sniecinski I, Margolin K, Shulman I, Oien L, Meyer E, Branch D R
City of Hope National Medical Center, Duarte, Calif.
Vox Sang. 1988;55(1):26-9. doi: 10.1111/j.1423-0410.1988.tb04683.x.
An example of an unusual cold autoagglutinin is reported. The antibody was monoclonal IgMKappa able to fix complement, and, in the presence of albumin, had both a high titer (greater than 4,096 at 4 degrees C) and a wide thermal range (4-37 degrees C). The patient was closely followed over a 3-year period with no evidence of hemolysis ever documented, despite a persistently positive direct antiglobulin test and the presence of the cold autoagglutinin. In contrast to previous reports regarding cold-agglutinin disease, this case demonstrates that in vivo hemolysis is not always associated with cold autoagglutinins that in vitro show a high thermal range in the presence of albumin.
