Hemostasis Today
NewsFeed
Headlines Hematology Health Medicine VTE ASH Plasma Donation
August, 2026
August 2026
M T W T F S S
 12
3456789
10111213141516
17181920212223
24252627282930
31  
Tareq Abadl on CAD: A Practical Guide to Suspicion, Confirmation, and Correction in the Lab
Dr. Tareq Abadl / LinkedIn
Dec 11, 2025, 03:05

Tareq Abadl on CAD: A Practical Guide to Suspicion, Confirmation, and Correction in the Lab

Tareq Abadl, Medical Laboratory Specialist and Director of the Blood Bank at Dr. Abdelkader Al-Mutawakkil Hospital, posted on LinkedIn:

“Cold Agglutinin Disease – What You Should Know

With winter coming, here’s an important lab concept: Cold Agglutinin Disease (CAD).

What Happens?

Tareq Abadl on CAD: A Practical Guide to Suspicion, Confirmation, and Correction in the Lab

In this condition, IgM antibodies become active at low temperatures.
Because IgM has 5 arms (pentamer), it can bind to many RBCs at once → causing agglutination/clumping of red blood cells.

How Do You Suspect It in CBC?

You’ll notice something strange:

Hemoglobin (Hb): Usually normal

MCV: Normal

MCH: High

MCHC: High

This unusual pattern should raise suspicion.

The Deciding Test?

Blood Film (Peripheral Smear)

Under the microscope you will typically see:
RBC Agglutination
This confirms the cause of the abnormal indices.

What About Hematocrit?

Using the simple calculation:
Hematocrit ≈ Hb × 3
You will find that the calculated hematocrit looks normal
— another clue pointing to cold agglutination interfering with automated counting.

How to Handle the Sample?

To fix the problem in the lab:

Warm the blood sample at 37°C before running CBC

After warming, results return to normal and reliable

Tip:
In cold weather, it’s a good practice to warm any CBC sample if results look inconsistent.”

Follow the latest in Hemostasis Today.

Blood Film CBC Cold Agglutinin Disease (CAD) Dr. Tareq Abadl Health Hematocrit Hematology Hemoglobin (Hb) Hemostasis Hemostasis Today IgM Medicine
NewsFeed