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.

Graphic 61974 Version 3.0

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Specificities and clinical and laboratory features of cold agglutinins