Korean J Blood Transfus.  2003 Dec;14(2):229-233.

Cold Agglutinin Disease due to Anti-Pr Cold Autoantibody in a Patient with Bone Marrow Transplantation

• Park HK
• Oh SH
• Choi KM
• Lee HK
• Kim DW

Abstract

Cold agglutinin disease (CAD) is a most common autoimmune hemolytic anemia (AIHA) induced by cold antibody. CAD represents approximately 16-32% of AIHA cases and causative cold autoantibodies commonly show specificity against the I antigen. We report a case of cold agglutinin disease with anti-Pr cold autohemolysin. A 20 year old woman with a history of bone marrow transplantation was admitted with nausea, vomiting, and pallor. Direct antiglobulin tests were positive with IgG and C3d specific AHG reagents. Cold agglutinin titer was as high as 1:1024 at 4degrees C, 1:16 at room temperature, negative at 37degrees C. The agglutinin titer was diminished after treatment with protease, ficin and immunohematologic results of cold agglutinin was compatible with anti-Pr specificity. In unexpected antibody identification test, anti-M which showed reactivity at anti-human globulin phase was identified. Washed and prewarmed 16 units of A+, M antigen negative red blood cells were transfused. After two weeks, patient was improved with steroid therapy and experienced relief of fever and hemolysis, and she was discharged.

Keyword

Cold agglutinin disease; AIHA; Anti-Pr

MeSH Terms

Anemia, Hemolytic, Autoimmune*
Autoantibodies
Bone Marrow Transplantation*
Bone Marrow*
Coombs Test
Erythrocytes
Female
Fever
Ficain
Hemolysis
Humans
Immunoglobulin G
Indicators and Reagents
Nausea
Pallor
Sensitivity and Specificity
Vomiting
Young Adult
Autoantibodies
Ficain
Immunoglobulin G
Indicators and Reagents