Abstract
Cold agglutinins (CA) represent IgM antibodies, which reversible interact with antigens on autologous erythrocytes at low temperatures. Most patients with CA remain asymptomatic, but in patients with high-titer and high-termal amplitude complications such as hemolysis, sludging of red blood cells with microvascular occlusion and decreased perfusion to various organ systems can cause unexpected morbidity and mortality. Among 2294 consecutive patients the screening revealed a positive reaction in 37 patients (1.6%). Specific CA were found in only five patients (0.2%) showing anti-I blood group specificity. The clinical significance of cold agglutininemia in patients requiring cardiac procedures using extracorporal circulation is discussed controversially. The discussion is focused on the necessity of routine pre-operative screening for cold agglutinins [2,3]. The very low incidence contrasts to the severe and sometimes lethal complications.
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