Ann Hematol (2017) 96:1767–1768 DOI 10.1007/s00277-017-3077-8 LETTER TO THE EDITOR Neutrophil aggregation on the peripheral blood smear in a patient with cold agglutinin disease Sigbjørn Berentsen Received: 13 June 2017 /Accepted: 12 July 2017 /Published online: 27 July 2017 Springer-Verlag GmbH Germany 2017 Dear Editor, The patient described had a normal hemoglobin concentra- In a recent issue of Annals of Hematology, Jong Ho Lee tion with a slightly elevated serum lactate dehydrogenase lev- describes a patient with neutrophil agglutination in her periph- el, while bilirubin was normal and other parameters of hemo- eral blood smear along with a cold agglutinin (CA) titer of lysis (absolute reticulocyte count and haptoglobin) were not mentioned. Furthermore, the published image shows aggluti- 512, positive direct antiglobulin test (DAT) for complement protein C3d and a pneumonic infiltrate on chest radiography nation of erythrocytes as well but no convincing . As stated by the author, such aggregation, if marked, will polychromasia or anisocytosis, even though this would be result in spurious white blood cell (WBC) counts. This is one better assessed at a higher magnification . Whereas the of a handful published case reports demonstrating clinical im- patient undoubtedly produced CA, it is remains possible
Annals of Hematology – Springer Journals
Published: Jul 27, 2017
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