Secondary cold-reactive autoimmune hemolytic anemia is found most ...

[Medesa]

Secondary cold-reactive autoimmune hemolytic anemia is found most often in patients with:
 
  a. Hemolytic disease of the newborn caused by anti-A or anti-D
  b. Acute myeloid leukemia and chronic myleogenous leukemia
  c. Mycoplasma pneumoniae or infectious mononucleosis
  d. Hereditary spherocytosis or hereditary elliptocytosis

Question 2

Red cell agglutination is found on a blood film. Select the best course of action.
 
  a. Report the morphology and all automated results.
  b. Warm the blood, and rerun it though the automated cell counter.
  c. Warm the blood, and make a new blood film.
  d. Perform a cold agglutinin test.

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Answer to Question 1

ANS: C
Cold-reactive autoimmune hemolytic anemia caused by anti-A or anti-D is sometimes secondary after infections such as M. pneumoniae and infectious mononucleosis.

Answer to Question 2

ANS: B
When red cell agglutination is noted on a blood film, the blood should be warmed to 37 C for 15 minutes and the automated analysis of the specimen repeated while the blood is warm. This patient most likely has a cold agglutinin, and it will disassociate from the red cell membrane and agglutination reverse when the specimen is warmed. Valid results can thus be obtained.