What is the role of urinalysis in the workup of cold agglutinin disease?

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

Perform urinalysis with microscopic assessment for red blood cells (RBCs) and a chemical test for hemoglobin to differentiate between hematuria and hemoglobinuria. Urinalysis can reveal hemoglobinuria, hemosiderinuria, and elevated urobilinogen.

Processing only fresh urine samples is an important means of avoiding in vitro hemolysis of RBCs in the urine, leading to an incorrect diagnosis of hemoglobinuria.

Urine immunoelectrophoresis should be performed if serum globulins are abnormal; only a 24-hour urine sample can be used to conclusively exclude the presence of light chains.


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