摘要
To the Editor,Cold agglutinin disease(CAD)is an IgM type of autoimmune disease with complement-mediated lysis of red blood cells(RBCs)usually characterized by clumping of RBCs.1 While RBC agglutination causes clinical symptoms of hemolytic anemia,agglutination caused by cold agglutinin is a notorious preanalytical and analytical factor that leads to spurious automated complete blood count results like falsely elevated mean corpuscular volume and decreased RBC count.2,3 The pathogenicity of IgM antibodies(Abs)and the peripheral smear findings are mainly determined by their thermal amplitude(TA)and clonality rather than their titers.To shed some light on this,the authors would like to present four cases of hemolytic anemia,which on further evaluation tested positive for polyspecific direct Coomb's test.
