EVALUATION OF CHRONIC PRIMARY COLD AGGLUTININ DISEASE ACTIVITY BY MEANS OF COLUMN AGGLUTINATION TECHNOLOGY

Abstract

We investigated the clinical course of one case to determine whether or not the level of false positive reaction detected with column agglutination technology (CAT) reflects the activity of primary chronic cold agglutinin disease (CAD). An 80-year old woman was diagnosed with primary chronic CAD, complicated with anemia and erythema of the breast. Oral prednisolone and cyclosporine A were used for immunosuppressive therapy. During the clinical course, erythema of the breast improved transiently but then became exacerbated again. The complement titer increased transiently, and the change in the complement level was linked with the activity of erythema. False positive levels on reverse typing test detected with CAT decreased when the complement level was suppressed, whereas the cold agglutinin titer showed limited change. We detected a false positive reaction on reverse typing test by means of CAT, the temperature of which was between 25 and 28°C. Investigation of the reaction between red blood cells and antibodies in this thermal range seems to be effective and feasible for the evaluation of the capability of the antigen-antibody complex. We speculate that detection of a false positive reaction on reverse typing test by means of CAT does indeed reflect the activity of primary chronic CAD.