Cold agglutinin

M. pneumoniae, if suspected by history or positive cold agglutinins (titers greater than or equal to 1 32) or if confirmed by culture or serology, may be treated with azithromycin. Also, a fluoroquinolone with activity against these pathogens (levofloxacin) may be used in adults. 

Some of the other findings encountered in WM include cold agglutinin hemolytic anemia, bleeding due to platelet dysfunction, and peripheral neuropathy (A7). 

Examples of antibodies Many Abs to toxins, bacteria, viruses especially late in Ab response. Many Abs to infectious agents, especially early in Ab response antipolysaccharide Ab cold agglutinins. Important as secretory antibody on mucous membranes. No proved Ab activity main immunoglobulin on surface of (8 lymphocytes in newborn. Binds to mast and basophil cells raised in allergic and parasitic infections. 

One of these is the blood group I-i system. Individuals with a disease termed chronic cold agglutinin disease generally have in their serum a monoclonal IgM autoantibody, active at 4°, that agglutinates human adult erythrocytes much more strongly than erythrocytes from the umbilical... 

A specific cold agglutinin cross-reacting with anti-N was detected in the sera of 68 (21%) of 325 hemodialysis patients each had used a dialyser that had been sterilized with formaldehyde. The results of transfusion experiments suggested in vivo hemolytic activity of this antibody. The authors postulated that such in vivo exposure to formaldehyde might make the MN-receptor on erythrocytes immunogenic, thus inducing the formation of the anti-N-like antibody. 

Blood bilirubin - increased Blood cold agglutinins - present Blood creatine kinase - increased Blood creatinine - increased [13]... 

Although estimates of the of IgM vary from 5 days (B7) to 10 days (04), Olesen used IgM cold agglutinins whose survival may have been influenced by repeated adsorption onto red cells, avoiding intracellular catabolism. 

Primary cold agglutinins are distinguished from those secondary to... 

A monoclonal band can be found in most cases, but serum must be separated at 37°C. The ESR in the cold is much higher than at 37°C, due to massive agglutination in the cold. The monoclonal IgM is readily measured (C14), averaging 0.4 g/100 ml (range 0.1-2.4). The residual IgM and IgA and IgG are usually normal. In some 30% patients, mostly those with high IgM levels, a subnormal level of IgA is found. The cold agglutinin IgM is mostly well produced, with no Bence Jones proteinuria or 7 S IgM, and, on a molecular basis, specific lytic activity against enzyme-treated red cells was very similar. 

Where Bence Jones proteinuria, 7 S IgM, subnormal IgG, or atypical cold agglutinin (anti-i, type L, etc.) are found, the probability of lymphosarcoma looms large (C2, C14). Some 10% of IgM lymphomata present with atypical cold agglutinins, and conversely disease terminates as lymphosarcoma. Apart from these, the prognosis is fair, for this would be a benign paraprotein in most cases, were it not for its hemolytic potential. 

III. In special areas (cryoproteins, cold agglutinins, rheumatoid factors, lichen myxedematosus, etc.) special studies will be needed. 

C13. Cooper, A. G., Chavin, S. I., and Franklin, E. C., Predominance of a single (x-chain subclass in cold agglutinin heavy chains. Immunochemistry 7, 479-483... 

C17. Costea, N., Yakulis, V., and Heller, P., Light-chain heterogeneity of cold agglutinins. Science 162, 1520-1521 (1966). 

MCV represents the average volume of RBCs. Cells are said to be macrocytic if they are larger than normal, microcytic if they are smaller than normal, and normocytic if their size falls within normal limits. Folic acid and vitamin B12 deficiency anemias yield macrocytic morphology, whereas iron deficiency and thalassemia are examples of microcytic anemias. A falsely elevated MCV occurs with reticulo-cytosis because reticulocytes are larger than erythrocytes. The MCV is also falsely elevated in the presence of cold agglutinins and hyperglycemia. When IDA (decreased MCV) is accompanied by folate deficiency (increased MCV), failure to understand that the MCV rep-... 

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