How is warm antibody–mediated autoimmune hemolytic anemia differentiated from cold agglutinin disease?

Updated: Aug 28, 2018
  • Author: Salman Abdullah Aljubran, MD; Chief Editor: Michael A Kaliner, MD  more...
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Answer

This must be differentiated from cold agglutinin disease, especially when no symptoms or findings suggest cold-induced acrocyanosis or Raynaud-type phenomenon. The cold agglutinin titer is a specific differentiating test, and a positive IgG-specific Coombs test result would exclude cold agglutinin disease. Examination of the peripheral blood smear is less specific, but finding typical RBC clumps would be unlikely in AIHA, unless it is a mixed IgG-IgM warm-cold autoimmune hemolytic anemia. [12, 15]


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