Hematology

Cold Agglutination of Erythrocytes: Mechanism and Elimination

What are cold agglutinins, how do they cause red blood cell clumping, and how to eliminate agglutination by warming a blood tube to 37°C in the lab.

Whole blood tubes: pronounced cold agglutination of erythrocytes
Whole blood tubes: pronounced cold agglutination of erythrocytes

Cold agglutinins are autoantibodies produced by the human immune system that mistakenly attack red blood cells. They cause agglutination (immunological clumping) of erythrocytes when a person is exposed to low temperatures and increase the likelihood of the affected red blood cells being destroyed by the body. Warming the blood sample and erythrocytes to 37 degrees Celsius for 10 minutes eliminates agglutination.