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

作　　者：Yanhong Cheng Yu Qin Maohong Bian Huiqin Wen Bangqiang Zhu Peng Yang Yanhong Cheng;Yu Qin;Maohong Bian;Huiqin Wen;Bangqiang Zhu;Peng Yang(Department of Blood Transfusion, The First Affiliated Hospital, Anhui Medical University, Hefei, China)

机构地区：[1]Department of Blood Transfusion, The First Affiliated Hospital, Anhui Medical University, Hefei, China

出　　处：《Case Reports in Clinical Medicine》2020年第8期247-254,共8页临床医学病理报告（英文）

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.<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.

关 键 词：Cold Agglutinin PLASMAPHERESIS TRANSFUSION 

分 类 号：R73[医药卫生—肿瘤]