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Shiny K. Kajal: Cold Agglutinins Can Mimic Macrocytosis on CBC
Shiny K. Kajal/LinkedIn
Feb 19, 2026, 13:36

Shiny K. Kajal: Cold Agglutinins Can Mimic Macrocytosis on CBC

Shiny K. Kajal, Senior Resident at Adesh University, shared a post on LinkedIn:

”Ever seen a CBC where:

  • MCV is high
  • RBC count is low
  • But hemoglobin looks perfectly fine?

Before labeling it macrocytosis… pause.

It might not be pathology.
It might just be temperature.

Cold agglutinins can trick automated analyzers —clumped RBCs masquerading as giant cells.

Warm the sample. Repeat the CBC.
Watch the ‘disease’ disappear.

Sometimes the lab mystery isn’t clinical —it’s immunohematology.”

Shiny K. Kajal: Cold Agglutinins Can Mimic Macrocytosis on CBC

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