Cold agglutinins
Agglutinins , even cold antibody ( cold-AK ) are IgM - autoantibodies in the blood that are effective only at low temperatures (10-15 ° C) and against a specific antigen (usually I or i) on the surface of red blood cells are directed.
effect
Cold agglutinins cause clumping ( agglutination ) of the erythrocytes, which can be regressed when the temperature rises, and thereby cause blockage of smaller blood vessels . Furthermore, cold agglutinins can lead to the dissolution of the erythrocytes ( hemolysis ). The corresponding clinical picture is called cold agglutinin disease .
meaning
Low titers (<1:64) are often measured in the serum or plasma of healthy people and are of no significance. In cold weather, higher titers can cause symptoms: pain, acrocyanosis , Raynaud's symptoms. An acute cold agglutinin syndrome can occur with infections with mycoplasma , occasionally also with EBV - mononucleosis or rubella . The chronic cold agglutinin syndrome occurs mainly in B-cell lymphomas or rarely also idiopathically . About 7–25% of autoimmune hemolytic anemias are believed to be caused by cold agglutinins.
Patients with cold agglutinins are only given warmed blood during blood transfusions . They are also not allowed to donate blood plasma themselves ; In the case of a whole blood donation , the plasma and the buffy coat are then destroyed.
In immunohematological diagnostics , cold agglutinins can interfere with examinations, e.g. B. the blood group determination , since these are also based on agglutination reactions.
The cold agglutinins are not to be confused with the cryoglobulins .
Web links
Individual evidence
- ^ H. Schubothe: Internal diseases caused by physical environmental factors. In: Ludwig Heilmeyer (ed.): Textbook of internal medicine. Springer-Verlag, Berlin / Göttingen / Heidelberg 1955; 2nd edition ibid. 1961, pp. 1161-1194, here: pp. 1165 f. ( Cooling down as a disease-causing factor ).
