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Biochemia Medica, Vol. 28 No. 3, 2018.

Case report

https://doi.org/10.11613/BM.2018.031001

Effect of cold agglutinins on red blood cell parameters in a trauma patient: a case report

Anita Topic orcid id orcid.org/0000-0003-1740-4397 ; Department of clinical chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Lara Milevoj Kopcinovic orcid id orcid.org/0000-0003-0360-9148 ; Department of clinical chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Ana Bronic orcid id orcid.org/0000-0001-7383-328X ; Department of clinical chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Marina Pavic orcid id orcid.org/0000-0003-0183-4712 ; Department of clinical chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia

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Abstract

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 1012/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.

Keywords

cold agglutinins; preanalytical errors; red blood cell count; spurious complete blood count results

Hrčak ID:

206790

URI

https://hrcak.srce.hr/206790

Publication date:

15.10.2018.

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