Donham J A, Denning V
Heart Lung. 1985 Jan;14(1):59-67.
Although cold agglutinin syndrome rarely results in an acute hemolytic episode, consideration should be given to the potential problems that exist when cold agglutinins are present. This autoimmune response may be present in an acute or chronic form. Viral and bacterial infections, especially mycoplasma pneumonia, may precipitate acute CAS, whereas, chronic CAS may be idiopathic or associated with malignant lymphoma. Both acute and chronic CAS may result in RBC hemolysis as the IgM antibody reacts with the I-antigen on the RBC, setting the complement cascade into action. Therefore, screening for cold agglutinins should be done before any procedure that would introduce cold fluids into the body, e.g., blood transfusions and cold cardioplegia during coronary artery bypass surgery.
尽管冷凝集素综合征很少导致急性溶血发作，但对于存在冷凝集素时可能出现的潜在问题应予以考虑。这种自身免疫反应可能以急性或慢性形式出现。病毒和细菌感染，尤其是支原体肺炎，可能引发急性冷凝集素综合征，而慢性冷凝集素综合征可能是特发性的或与恶性淋巴瘤相关。急性和慢性冷凝集素综合征均可导致红细胞溶血，因为IgM抗体与红细胞上的I抗原发生反应，从而启动补体级联反应。因此，在任何会将冷液体引入体内的操作之前，如输血和冠状动脉搭桥手术中的冷心脏停搏液灌注，都应进行冷凝集素筛查。
