What is the role of reticulocytes and spherocytes count 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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The results of the reticulocyte count are usually increased in patients with cold agglutinin disease, with polychromasia in the peripheral blood smear. The mean corpuscular volume (MCV) is elevated because of reticulocytosis, as well as agglutination of the RBCs.

However, reticulocytosis may be inadequate for the degree of anemia in the patient. This may be due to decreased erythropoiesis caused by an underlying infection.

Spherocytes may be present, although less prominently than in warm autoantibody–induced hemolytic anemias. (See the image below).

Blood smear showing spherocytic and agglutinated r Blood smear showing spherocytic and agglutinated red blood cells.

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