In the case presented by the authors, IgM type autoantibodies lead to agglutination and hemolysis of erythrocytes by adhering to erythrocyte surface with complement (C3b) opsonization at low temperature (3-4 [degrees]C) in cold antibody
AIHA (cold agglutinin disease) which the authors were focused on and which frequently occurs secondary to infections (1, 2, 4, 5).
Because of the high cost of commercial anti-hAXL antibody, we did not include cold antibody
as the blocking agent for microPET/CT imaging.
Aside from prewarming the specimens, circumventing an offending cold antibody
can be done by using 22% bovine serum albumin instead of low ionic-strength solutions because some cold RBC autoantibodies are enhanced by low ionic-strength solutions.
Successful Treatment of a Patient with Mixed Warm and Cold Antibody
Mediated Evans Syndrome and Glucose Intolerance.
Petz, "Cold antibody
autoimmune hemolytic anemias," Blood Reviews, vol.