• Journal of Chest Surgery
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• v.47 no.2
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• pp.133-136
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• 2014

Cold agglutinins are predominately immunoglobulin M autoantibodies that react at cold temperatures with surface antigens on the red blood cell. This can lead to hemagglutination at low temperatures, followed by complement fixation and subsequent hemolysis on rewarming. Development of hemagglutination or hemolysis in patients with cold agglutinins is a risk of cardiac surgery under hypothermia. In addition, there is the potential for intracoronary hemagglutination with inadequate distribution of cardioplegic solutions, thrombosis, embolism, ischemia, or infarction. We report a patient with incidentally detected cold agglutinin who underwent normothermic cardiac surgery with warm blood cardioplegia.

• Journal of Chest Surgery
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• v.22 no.2
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• pp.305-307
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• 1989

Cold agglutinins are a potential danger to patients who must be subjected to hypothermia. A patient with a cold agglutinin of moderate titer but broad thermal amplitude was to undergo hypothermia during double valve replacement. She was managed preoperatively with plasmapheresis 5 times. There was no complication during and after operation.

• Pediatric Infection and Vaccine
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• v.16 no.2
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• pp.215-219
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• 2009

Mycoplasma pneumoniae is a common cause of community-acquired pneumonia in children, with a peak incidence at 5-14 years. Extrapulmonary manifestations occur in 20-25% of patients with M. pneumoniae infection. Most auto-antibodies that cause immune hemolytic anemia in humans are cold agglutinins. The formation of cold agglutinins is frequently observed during M. pneumoniae infections, and cold agglutinin disease usually occurs during M. pneumoniae infections. Nevertheless, severe hemolysis is exceptional. If a patient has any underlying disease related to hemolysis, it is possible to accelerate hemolysis. Hereditary spherocytosis is a common cause of hereditary hemolytic anemia resulting from red blood cell membrane defects. Hemolysis of red cells may result from corpuscular abnormalities or extracorpuscular abnormalities, such as immune or non-immune mechanisms. We report a case of hereditary spherocytosis associated with severe hemolytic anemia due to Mycoplasma pneumonia.

• Journal of Chest Surgery
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• v.34 no.10
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• pp.797-799
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• 2001

Open heart surgery with hypothermia in patients with cold agglutinin can cause severe complications by hemolysis and hemagglutination of red blood cells. A 41 year-old male patient with mitral stenosis was admitted due to fever and cough. After antibiotics treatment, he was scheduled to undergo mitral valve replacement. In the operation room, we found agglutination of blood cardioplegia during lowering temperature of cardioplegia. And then, the cardioplegia was changed to warm cardioplegia and the operation was performed under normothermia due to the suspicion of the cold reactive protein. The operation was performed uneventfully. Postoperatively, cold agglutinin was confirmed by immunochemistry of the patient\`s serum.

• Pediatric Infection and Vaccine
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• v.4 no.2
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• pp.271-275
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• 1997

We experienced a case of Henoch-Sch$\ddot{o}$nlein purpura associated with Mycoplasma pneumoniae pneumonia in a 28 month old male who suffered from cough, abdominal pain and both leg swelling and pain. Physical examination showed varying sized purpura, characteristic of Henoch-Sch$\ddot{o}$nlein purpura, below both knee. Laboratory test revealed Mycoplasma pneumoniae antibody titer >1:2,560 and cold agglutinins titer 1:64. Chest X-ray showed peribronchial blurring in both lung fields. The patient was treated with midecamycin and prednisolone for 7 days and responded to the treatment well. The authors report a case of Henoch-Sch$\ddot{o}$nlein purpura with Mycoplasma pneumoniae pneumonia with brief review of related literatures.