The membrane lipid fluidity of normal human erythrocytes was modified by enrichment and depletion in cholesterol, and the expression of I and SP1 antigens was assayed by quantitative hemagglutination from 4 degrees to 24 degrees C by use of a continuous flow system. Below 16 degrees--18 degrees C, cholesterol enrichment increased and cholesterol depletion decreased percent agglutination. As temperatures approached approximately 18 degrees--20 degrees C, differences in agglutination between modified and unmodified erythrocytes became insignificant despite marked differences in lipid fluidity at that temperature. Thus, fluidity changes alone cannot be responsible for the effect of membrane cholesterol on cold agglutination. In an additional study, the temperature dependence of a relative equilibrium association constant, estimated by probit analysis of percent agglutination at various antisera concentrations, was biphasic with a sharp break at 16 degrees C. Our studies are consistent with the hypothesis that I and Sp1 antigens preferentially partition into a lipid domain that forms during lateral phase separation of membrane lipid developing at low temperature. A resulting increase in antigen density would then become responsible for augmented agglutination by specific antibody.
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Med Int (Lond)
December 2024
Department of Hematology, Dokuz Eylul University Hospital, Izmir 35000, Turkey.
Cold agglutinin syndrome is a form of acquired hemolytic anemia that typically arises from underlying conditions, such as infections, autoimmune disorders or lymphoid malignancies. The majority of patients remain asymptomatic and are diagnosed with anemia through routine complete blood count (CBC) testing. The present study describes the case of a male patient in his 50s who sought a second opinion at the authors' clinic due to newly detected anemia.
View Article and Find Full Text PDFTransfusion
January 2025
Department of Blood Transfusion, Fujita Health University Hospital, Toyoake, Japan.
Background: Ethylenediamine tetraacetate/glycine acid (EGA) and chloroquine diphosphate (CDP) are used in transfusion testing to dissociate IgG antibodies from red blood cells (RBCs). However, the ability of these reagents to dissociate IgM antibodies sensitized to RBCs has not been comprehensively elucidated. We investigated whether EGA and CDP could dissociate cold-reactive antibodies from RBCs and their effect on RBCs after dissociation treatment.
View Article and Find Full Text PDFCureus
December 2024
Department of Internal Medicine, Uwajima City Hospital, Uwajima, JPN.
We report a case of coexisting cold agglutinin and cryoglobulin in a patient with severe anemia following COVID-19 infection, in whom direct antiglobulin testing revealed C3d positivity and immunoglobulin G negativity. There was no evident hemolytic anemia, thrombosis, or clinically significant IgM monoclonal gammopathy. The anemia improved with folic acid supplementation alone accompanied by a decrease of the cold agglutination titer, and the direct antiglobulin test became negative.
View Article and Find Full Text PDFBiochem Med (Zagreb)
February 2025
Department of Medical Biochemistry and Hematology, Children's Hospital Zagreb, Zagreb, Croatia.
Ceftriaxone, a widely used antibiotic, is one of the most common drugs to cause drug-induced immune hemolytic anemia. In this report, we describe the effect of ceftriaxone on red blood cell parameters (low red blood cell count, low hematocrit, and high erythrocyte index values) in two pediatric patients without clinical symptoms of hemolytic anemia. Although automated hematology analyzers have helped to detect incorrect results, a peripheral blood smear examination was necessary for recognizing the erythrocyte agglutinins caused by ceftriaxone.
View Article and Find Full Text PDFCold agglutinin disease (CAD) is a rare autoimmune hemolytic anemia caused by cold-reactive IgM antibodies leading to complement-mediated hemolysis. While CAD-associated venous thromboembolism is recognized, its role in arterial thromboembolic events, particularly ischemic stroke, is poorly defined. We report an 84-year-old woman who developed acute onset upper left extremity weakness following exposure to sub-zero temperatures.
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