Cold-Reactive Autoantibodies - Investigation:

Specificity, Titer & Thermal Amplitude

The masking effects of a cold-reactive autoantibodies can be removed with the same adsorption procedures used for warm-reactive autoantibodies; alternatively, extending the length of the 37ºC incubation phase of the IAT, or removing all IgM antibodies by treating patient plasma with a reducing reagent such as DTT may help clear IgM cold agglutinins while preserving IgG alloantibodies.

Performing all phases of pre-transfusion compatibility testing at 37ºC (also known as prewarming) should be avoided, however, as it may inadvertently remove clinically significant alloantibodies from detection.

A number of additional investigations may be performed to further characterize a cold agglutinin:

Table 1

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