Reduction of High-Titer Cold Agglutinins by Plasmapheresis to Resolve Serological Problem in a Patient

• 作者: Peng Yang
• 来源期刊: 临床医学病理报告(英文)
• 学科: 医学
• 关键词: Cold Agglutinin PLASMAPHERESIS TRANSFUSION
• 年，卷（期）: 2020,（8）
• 页码范围: 247-254
• 页数: 8页
• 分类号: R73

摘要

<strong>Background:</strong> Cold agglutinins are auto-antibodies that can be a nuisance in cross matching and in blood grouping. Here we report an unusual case of a high titer and wide amplitude cold agglutinin reduced by plasmapheresis. <strong>Methods and Materials:</strong> A 56-year-old man with severe anemia requested a transfusion of red blood cells. However, there was a problem in blood for blood grouping. The discrepancy of blood typing was subsequently resolved using group O absorbed plasma along with repetition of forward grouping with warm-washed red blood cells. The presence of high-thermal-amplitude and a high-titer anti-I cold agglutinin were detected in further serologic investigation. It revealed reactivity against autologous and adult O red blood cells at 37<span style="white-space:nowrap;">&deg;</span>C by the thermal amplitude screening test, and demonstrated a very high titer of 65,536 against adult O cells by titration studies at 4<span style="white-space:nowrap;">&deg;</span>C. The patient received two plasma exchange sessions of 1.5 plasma volumes each. There was a significant reduction of the titer of cold agglutinins and of the thermal amplitude by plasmapheresis as well (<em>p</em> < 0.01). <strong>Results:</strong> After successful cross-matching with post plasma exchanges, four units of red blood cells were infused to the patient without any hemolysis symptoms or signs. <strong>Conclusions:</strong> We now reported a patient with abnormally ascended titer of cold agglutinins and wide-thermal-amplitude, but we also successfully performed ABO typing and cross matching after 2 plasma exchange sessions of 1.5 plasma volumes each.