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Cold Agglutination


In this blood sample all RBC and PLT results were invalidated by the MCHC alarm, triggered by the extremely high MCHC. This was due to a large discrepancy between HGB concentration and RBC count. The sample contained cold agglutinins, causing aggregates of RBC that fell outside the window of analysis. This could easily be seen in the RBC histogram, where there was an abnormal irregular area and a distinct peak on the right side of the RBC population indicating the presence of large RBC (as a result of the RBC agglutination).

Numerical Results

WBC 6.54 10e3/μL
NEU 4.211 64.446 %
BLST .002 .033 %
MONe .570 8.72 %
EOS .088 1.35 %
BASO .036 .544 %
LYM 1.629 24.954 %

RBC 3.53* 10e6/μL
HGB 13.8* g/dL
HCT 33.4* %
MCH 39.1  pg
MCHC 41.3 g/dL  MCHC
RDW 15.7 %

PLT 150.* 10e3/μL
MPV 5.38* fL

CELL-DYN Ruby Casebook. Cold Agglutination. 2018. ADD-00005070. p.49
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