Analysis index

Collect 3 ml whole blood in a pre-heated tube (monovette tube), let it clot at 37°C (incubator or water bath) and after 30 min centrifuge it for 5 min. Divide serum from blood clot at once and send both to the laboratory. An additional 2 ml EDTA-blood is required for direct Coombs test.

Low-titric cold agglutinins up to titers of 1:16 at 4°C are classed as normal.

Immune hemolytic anemia of the cold type.

There are two forms of cold agglutinin diseases:

1. Post-infectious transitory form with temporarily pathologically increased titers up to 1:1024 in case of

• Atypical pneumonia caused by mycoplasma pneumoniae
• Infectious mononucleosis caused by Epstein-Barr virus
• Infection by cytomegalovirus

2. Chronic forms with high-titric values of 1:1024 to 1:1 million in case of

• Monoclonal gammopathy, mostly IgM/Kappa (Waldenström’s disease)
• Lymphatic leukemia