Ukr.Biochem.J. 2017; Volume 89, Issue 2, Mar-Apr, pp. 116-120


A novel method for negating cold agglutination interference by dithiothreitol during complete blood count and peripheral blood smear: a case study

Hamit Yasar Ellidag*, Sibel Kulaksizoglu, Esin Eren, Necat Yilmaz

Central Laboratories of Antalya Training and Research Hospital, Antalya, Turkey;

Cold agglutinin disease is an autoimmune disorder that is characterized by antibodies attacking polysaccharide antigens on one’s own erythrocytes. In cold agglutinin disease, hemolysis occurs due to degeneration of erythrocyte membranes and autoagglutination of erythrocytes. Both autoagglutination and hemolysis alter many laboratory test results of the patients, especially complete blood count (CBC) and peripheral blood smear analyses. In our laboratory, we have encountered a blood sample of a 65-years-old man, who was independently diagnosed with cold agglutinin disease, and failed to produce meaningful CBC or peripheral blood smear analysis. Fresh blood samples were taken from the patient, and CBC and peripheral blood smear analyses were repeated with and without water bath incubation at 37 °C. Also, varying amounts of dithio­threitol (DTT) were added to fresh samples without heat treatment prior to blood analysis. Heat treatment at 37 °C for varying lengths of time failed to improve CBC and peripheral blood smear analysis. On the other hand, addition of DTT into a blood sample of 2 ml in a K3-EDTA tube was sufficient to negate cold agglutination interference during both CBC and peripheral blood smear analyses. The presented method supports the potential for DTT to be used in negating cold agglutination interference during CBC and peripheral blood smear analyses of patients with cold agglutinin disease. The method we describe is very easy and quick with remarkable results.

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