Cold agglutinin disease related mismatch between hematocrit and hemoglobin values


  • Emre Hoca Internal Medicine Clinic, Üsküdar State Hospital, İstanbul
  • Fatma Pınar Ziyadanoğlu Internal Medicine Clinic, Haseki Training and Research Hospital, İstanbul
  • Atay Can Kula Internal Medicine Clinic, Haseki Training and Research Hospital, İstanbul
  • Hayriye Esra Ataoğlu Internal Medicine Clinic, Haseki Training and Research Hospital, İstanbul



Cold agglutinin disease, Hemoglobin-hematocrite mismatch, Epstein-Barr virus


Autoimmune hemolytic anemia is a disease characterized by destruction of red blood cells (RBC) and anemia, caused by production of antibodies released against the body’s own RBCs. While this condition is more commonly idiopathic, it may accompany autoimmune diseases as well. Cold agglutinin disease (CAD) is a rare subtype of acquired autoimmune hemoliytic anemia, however, is an idiosyncratic clinical and pathological terminology, usually seen in older ages. This condition is caused by IgM antibodies called “cold agglutinins” formed against I antigens on RBC membranes which cause agglutination of RBCs at lower temperatures. In this case, a 56 year old male patient who was diagnosed with CAD secondary to Epstein-Barr virus (EBV) infection is being presented.


Swiecicki PL, Hegerova LT, Gertz MA. Cold agglutinin disease. Blood. 2013;122(7):11-4.

Berentsen S. How I manage patients with cold agglutinin disease. Br J Haematol. 2018;181(3):320.

Yenigün M, Türker T, Ataoğlu HE, Temiz LE, Ahbab S. From obesity to diabetes. Haseki Tıp Bülteni. 2005;43:1-12.

Saler T, Keşkek SO, Ahbab S, Cakir S, Ortoğlu G, Bankir M, et al. Frequency of Hashimoto's thyroiditis in women with vitamin D deficiency: A cross sectional study. Am J Int Med. 2014;2(3):44-8.

Atasoy A, Atay A, Ahbab S, Hanedar M, Yenigün M. Diyabetik nefropatiye genel bir bakış. Haseki Tıp Bülteni. 2015;53:16-9.

Saler T, Keşkek ŞÖ, Kırk S, Ahbab S, Ortoğlu G. H. pylori May Not Be Associated with Iron Deficiency Anemia in Patients with Normal Gastrointestinal Tract Endoscopy Results. Adv Hematol. 2014;375915:4.

Berentsen S, Ulvestad E, Langholm R, Beiske K, Hjorth-Hansen H, Ghanima W, et al. Primary chronic cold agglutinin disease: a population based clinical study of 86 patients. Haematologica. 2006;91(4):460.

Zilow G, Kirschfink M, Roelcke D. Red cell destruction in cold agglutinin disease. Infusionsther. Transfusions Med. 1994;21(6):410.

Baines AC, Brodsky RA. Complementopathies. Blood Rev. 2017;31(4):213.

Crisp D, Pruzanski W. B-cell neoplasms with homogeneous cold-reacting antibodies (cold agglutinins). Am J Med. 1982;72(6):915.

Horwitz CA, Moulds J, Henle W, Henle G, Polesky H, Balfour HH, et al. Cold agglutinins in infectious mononucleosis and heterophil-antibody-negative mononucleosis-like syndromes. Blood. 1977;50(2):195.

Oshima M, Maeda H, Morimoto K, Doi M, Kuwabara M. Low-titer cold agglutinin disease with systemic sclerosis. Intern Med. 2004;43(2):139.

Nikousefat Z, Javdani M, Hashemnia M, Haratyan A, Jalili A. Cold Agglutinin Disease; A Laboratory Challenge. Iran Red Crescent Med J. 2015;17(10):e18954.

Gertz MA. Management of cold haemolytic syndrome. Br J Haematol. 2007;138(4):422-9.




How to Cite

Hoca, E., Ziyadanoğlu, F. P., Kula, A. C., & Ataoğlu, H. E. (2020). Cold agglutinin disease related mismatch between hematocrit and hemoglobin values. International Journal Of Community Medicine And Public Health, 7(2), 770–772.



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