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Specificities and clinical and laboratory features of cold agglutinins

Specificities and clinical and laboratory features of cold agglutinins
Specificity Antigen structure Typical intensity of antibody reaction: Antibody class and clonality Typical clinical presentation
Adult RBC Fetal RBC Protease-treated RBC Sialidase-treated RBC
Anti-I Branched aminyllactose polymers ++++ + ++++ ++++ IgM, monoclonal Chronic cold agglutinin, lymphoproliferative disorders
IgM, polyclonal Mycoplasma pneumoniae infection, other viruses
Anti-i Linear aminyllactose polymers + ++++ ++++ +++++ IgM, monoclonal Lymphoid malignancies
IgM, polyclonal Infectious mononucleosis
Anti-Pr Polysaccharides on glycoproteins ++++ ++++ 0 0 to ++++ IgM, monoclonal Lymphoproliferative disorders or lymphoid malignancies
Others Polysaccharides containing sialic acid +++ +++ +++ 0 IgM, monoclonal Lymphoproliferative disorders or lymphoid malignancies
These are common findings but are not considered diagnostic; the underlying disorder cannot be inferred from the details of antibody specificity. Refer to UpToDate for further information about cold agglutinin disease.
RBC: red blood cell; Ig: immunoglobulin.
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