Hematology

Cold Agglutination in Complete Blood Count: A Case Study

A case of cold agglutination: false MCHC elevation, sample appearance in tube and microscopy, and parameter correction after 37°C incubation.

A 67-year-old female patient with cold agglutination of erythrocytes. Blood also shows elevated Ig M 1132 mg/dL (N= 40-230). Hb 7.8 g/dL, MCHC 92 g/dL ! (N 32-35), MCH 81.4 pg (N 27-31). After incubation in a 37° water bath: Hb 9.2g/dL, MCHC 35.1g/dL, MCH 32 pg.

This is how cold agglutination appears in the tube, on the slide, and under the microscope. Monoclonal lymphocytes were not detected by immunophenotyping.