AUTOHEMAGGLUTININS —“COLD AGGLUTININS”1

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Abstract
The description of cold agglutinins associated with atypical pneumonia prompted the present study. Using the method of Ham and Finland, cold agglutinins were tested for in patients with atypical pneumonia, tracheobronchitis, the common cold, influenza, and variety of diseases from a general hospital. Each patient had 2 or more samples of blood drawn, the last being 14 days or longer after the acute onset of illness. Maximum titers in serum dilutions were recorded. 32 out of 46 virus pneumonia patients (69%) had a titer of 1:40 or more. 18 of the 46 patients (39%) had a titer of 1:160 or more. 12 of 27 tracheobronchitis patients (45%) had a titer of 1:40 or more. 5 of 15 patients with common colds had a titer of 1:40 or more. Influenza patients did not develop significant cold agglutinins. Three patients were studied through many months during which time they had atypical pneumonia, colds and other minor illnesses. Cold agglutinin titers rose with the minor illnesses to levels as high as those observed with atypical pneumonia. Among hospital patients cold agglutinin titers of 1:40 or more were observed occasionally in German measles, chicken pox, ornithosis, trachoma, [beta] hemolytic streptococcal infection, complicated lobar pneumonia, leukemia, hemolytic anemia, infectious mononucleosis, acute hepatitis, and disseminated lupus erythematosus. The highest titer observed was in a terminal myeloid leukemia (1:280,000). The cold agglutinin test is most useful in the diagnosis of atypical pneumonia but is not pathognomonic unless interpreted , with clinical findings.

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