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Agglutinine Fredde

Articolo approvato dal Comitato editoriale di labtestsonline.org ed in corso di revisione da parte del Comitato editoriale italiano

In Sintesi

Perché?

Per stabilire la causa di anemia emolitica e come sostegno alla diagnosi della malattia delle agglutinine fredde.

Quando?

In presenza di sintomi correlati con l'anemia e/o dolore, pallore, colorazione bluastra delle dita di mani, piedi e delle estremità delle orecchie dopo l'esposizione alle basse temperature; come esame di approfondimento in seguito alla diagnosi di anemia emolitica.

Il campione

Un campione di sangue venoso prelevato dal braccio.

La preparazione

No, nessuna.

L'Esame

Le agglutinine fredde sono autoanticorpi prodotti dal sistema immunitario in grado di riconoscere erroneamente i globuli rossi. La presenza delle agglutinine causa, in seguito all'esposizione alle basse temperature, l'aggregazione dei globuli rossi. L'agglutinazione può comportare la distruzione dei globuli rossi operata dall'organismo. Questo test rileva e misura la quantità di agglutinine fredde nel sangue.

La distruzione significativa dei globuli rossi dovuta alla presenza di agglutinine fredde, può portare ad anemia emolitica con diminuzione del numero dei globuli rossi e dell'emoglobina. Questa rara forma autoimmune di anemia emolitica e nota con il nome di malattia da agglutinine fredde. La malattia da agglutinine fredde può essere primaria (idiopatica) o secondaria, se indotta da altre patologie o condizioni cliniche come le infezioni (Mycoplasmapneumoniae), le malattie linfoproliferative, le malattie autoimmuni sistemiche o alcune patologie tumorali.

La malattia da agglutinine fredde primaria in genere interessa persone di mezza età o anziane, ed ha una forte tendenza a cronicizzarsi. La malattia da agglutinine fredde secondaria invece può colpire persone di qualunque età e può essere acuta o cronica, temporanea o persistente.

Il test delle agglutinine fredde non viene richiesto routinariamente. Si tratta di un test che in passato è stato largamente utilizzato maviene usato sempre meno da quando sono diventati disponibili test più specifici per la ricerca delle cause secondarie, come l'infezione da Mycoplasmapneumoniae.

Come e Perchè

Quali informazioni è possibile ottenere?

Il test delle agglutinine fredde può essere utilizzato come sostegno alla diagnosi della malattia da agglutinine fredde e per ricercare la causa di anemiaemolitica. Può essere richiesta come esame di approfondimento in seguito al riscontro di valori alterati al test dell'emocromo, come la diminuzione del numero dei globuli rossie dell'emoglobina, in particolare nel caso in cui queste alterazioni appaiano essere correlate all'esposizione alle basse temperature.

La malattia da agglutinine fredde è una rara patologia autoimmune, nella quale gli autoanticorpi prodotti dal sistema immunitario della persona affetta, legano e distruggono gli eritrociti portando ad anemia emolitica. Questi autoanticorpi reagiscono alle basse temperature e possono pertanto causare i segni e sintomi tipici in seguito all'esposizione della persona affetta a queste temperature. Questa malattia viene classificata come primaria o secondaria, se innescata da un'infezione o altre patologie.

Domande Frequenti

E' possibile fare qualcosa per diminuire o eliminare le agglutinine fredde?

E' possibile fare qualcosa ma per questo è necessario rivolgersi al proprio medico che, sulla base della situazione specifica, potrà individuare le strategie più adatte.

Fonti

Fonti utilizzate nella revisione corrente

Lewinsohn, D, et. al. (2017 January 03). Official American Thoracic Society/Infectious Diseases Society of America/Centers for Disease Control and Prevention Clinical Practice Guidelines: Diagnosis of Tuberculosis in Adults and Children. Clinical Infectious Diseases, Volume 64, Issue 2, 15 January 2017, Pages 111–115. Available online at https://academic.oup.com/cid/article/64/2/111/2811357. Accessed on 8/05/18.

Vyas, J. et. al. (2016 November 14, Updated). Sputum stain for mycobacteria. MedlinePlus Medical Encyclopedia. Available online at https://medlineplus.gov/ency/article/003724.htm. Accessed on 8/05/18.

Koirala, J. (2017 November 14, Updated). Mycobacterium Avium Complex (MAC) (Mycobacterium Avium-Intracellulare [MAI]). Medscape Infectious Diseases. Available online at https://emedicine.medscape.com/article/222664-overview. Accessed on 8/05/18.

Herchline, T. and Amorosa, J. (2017 November 9, Updated). Tuberculosis (TB). Medscape Infectious Diseases. Available online at https://emedicine.medscape.com/article/230802-overview. Accessed on 8/05/18.

Batra, V. and Ang, J. (2018 April 26, Updated). Pediatric Tuberculosis. Medscape Pediatrics: General Medicine. Available online at https://emedicine.medscape.com/article/969401-overview. Accessed on 8/05/18.

Barker, A. (2018 July, Updated). Mycobacterium tuberculosis – Tuberculosis. ARUP Consult. Available online at https://arupconsult.com/content/mycobacterium-tuberculosis. Accessed on 8/05/18.

Fonti utilizzate nelle precedenti revisioni

Thomas, Clayton L., Editor (1997). Taber's Cyclopedic Medical Dictionary. F.A. Davis Company, Philadelphia, PA [18th Edition].

Pagana, Kathleen D. & Pagana, Timothy J. (2001). Mosby's Diagnostic and Laboratory Test Reference 5th Edition: Mosby, Inc., Saint Louis, MO.

Heimerdinger, M. (2000). Tuberculosis. ACP-ASIM [On-line session report]. Available online at http://www.acponline.org/vas2000/sessions/tb.htm.

Kirchner, J. (2000 February 1). Do Sputum Smears Positive for AFB Signify Treatment Failure? American Family Physician [On-line journal]. Available online at http://www.aafp.org/afp/20000201/tips/25.html.

Jerant, A. et.al. (2000 May 1). Identification and Management of Tuberculosis. American Family Physician [On-line journal]. Available online at http://www.aafp.org/afp/20000501/2667.html.

Sadovsky, R. (2001 May 15). Making the Diagnosis of Tuberculosis in Children. American Family Physician [On-line journal]. Available online at http://www.aafp.org/afp/20010515/tips/9.html.

Centers for Disease Control and Prevention (2002 August 13, Reviewed). Frequently Asked Questions, Questions and Answers about TB. National Center for HIV, STD and TB Prevention Division of Tuberculosis Elimination [On-line information]. Available online at http://www.cdc.gov/nchstp/tb/faqs/qa.htm.

Tuberculosis. The Merck Manual of Medical Information--Home Edition [On-line information]. Available online at http://www.merck.com/pubs/mmanual_home/sec17/181.htm.

Tan, L.J. (2000 June 28, Updated). ATS/CDC Statement Revises Treatment and Testing for Latent TB Infection. American Medical Association [On-line information]. Available online at http://www.ama-assn.org/ama/pub/article/1865-2125.html.

Mazurek, G. & Villarino, M. (2002 December 18 Updated). Guidelines for Using the QuantiFERON®-TB Test for Diagnosing Latent Mycobacterium tuberculosis Infection. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report [On-line report]. Available online at http://www.cdc.gov/mmwr/preview/mmwrhtml/di51cha1.htm.

Centers for Disease Control and Prevention (2002 March 23, Reviewed). TB and HIV Coinfection. National Center for HIV, STD and TB Prevention, Division of Tuberculosis Elimination [On-line information]. Available online at http://www.cdc.gov/nchstp/tb/pubs/TB_HIVcoinfection/default.htm.

Tuberculosis: Ancient Enemy Present Threat, "I must die": Tuberculosis in History. NAIAD [On-line information]. Available online at http://www.niaid.nih.gov/newsroom/focuson/tb02/story.htm.

Tuberculosis (TB). American Lung Association [On-line information]. Available online at http://www.lungusa.org/diseases/lungtb.html.

(2002 January). American Lung Association® Fact Sheet: Tuberculosis. ALA [On-line information]. Available online at http://www.lungusa.org/diseases/tbfac.html.

(2002 January). American Lung Association® Fact Sheet: Tuberculosis Skin Test. ALA [On-line information]. Available online at http://www.lungusa.org/diseases/tbskinfac.html.

(2002 January). American Lung Association® Fact Sheet: Pediatric Tuberculosis. ALA [On-line information]. Available online at http://www.lungusa.org/diseases/pedtbfac.html.

NIAID (1999 December 1, Updated). The Global Burden of Tuberculosis. National Institute of Allergy and Infectious Diseases, National Institutes of Health [On-line publication]. Available online at http://www.niaid.nih.gov/publications/blueprint/page2.htm.

Tuberculin skin test. Hendrick Health System AccessMed [On-line information]. Available online at http://www.hendrickhealth.org/healthy/00069330.html.

Tuberculosis. Hendrick Health System AccessMed [On-line information]. Available online at http://www.hendrickhealth.org/healthy/00069340.html.

Mycobacteriology, Introduction to the Genus Mycobacteria. Microbiology Public Health for Northern Alberta, Bugs on the Web [On-line information]. Available online at http://www2.provlab.ab.ca/bugs/mycob/mbintro.htm.

Mycobacteriology, Acid-Fast Staining Procedures for Mycobacteria. Microbiology Public Health for Northern Alberta, Bugs on the Web [On-line information]. Available online at http://www2.provlab.ab.ca/bugs/mycob/afb_stain/afb_tutorial.htm.

Hall, G. (2001). Practical Microbiology, Update on Broth Media for the Isolation of Mycobacterium Species. Medscape from Infect Med 18(1):28-30, 2001 [On-line journal]. Available FTP: http://www.medscape.com/viewarticle/410131.

Tuberculin Purified Protein Derivative (Mantoux) Tubersol. Aventis Pasteur Inc. (Swiftwater, PA) [Package Insert].

(1996 October 28, Rev L). AccuProbe, Mycobacterium Tuberculosis Complex Culture Identification Test. Gen-Probe [Package Insert]. Available online at http://www.gen-probe.com/mtd.html.

(2006 November 3). Notice to Readers: Revised Definition of Extensively Drug-Resistant Tuberculosis. CDC MMWR 55(43);1176 [On-line information]. Available online at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5543a4.htm. Accessed December 10, 2006.

(2006 April). Tuberculosis: General Information. National Center for HIV, STD, and TB Prevention, Division of Tuberculosis Elimination Fact Sheet [On-line information]. Available online at http://www.cdc.gov/nchstp/tb/pubs/tbfactsheets/250010.htm. Accessed December 10, 2006.

(2006 March, Revised). Tuberculosis. World Health Organization [On-line information]. Available online at http://www.who.int/mediacentre/factsheets/fs104/en/index.html. Accessed December 10, 2006.

(2006 March). Tuberculosis. Accessed December 10, 2006. NIAID Fact Sheet [On-line information]. Available online at http://www.niaid.nih.gov/factsheets/tb.htm.

(2006 April). Diagnosis of Tuberculosis Disease. National Center for HIV, STD, and TB Prevention, Division of Tuberculosis Elimination Fact Sheet [On-line information]. Available online at http://www.cdc.gov/nchstp/tb/pubs/tbfactsheets/250102.htm. Accessed December 10, 2006.

Pagana, Kathleen D. & Pagana, Timothy J. (© 2007). Mosby's Diagnostic and Laboratory Test Reference 8th Edition: Mosby, Inc., Saint Louis, MO. Pp 955-957.

Moore, DAJ et al. Microscopic-Observation Drug-Susceptibility Assay for the Diagnosis of TB. New England Journal of Medicine2006;355:1539-1550.

Forbes BA, Sahm DF, Weissfeld AS, Bailey & Scott's Diagnostic Microbiology 12th Edition: Mosby Elsevier, St. Louis, MO; 2007, Pp 478-508.

Centers for Disease Control and Prevention (July 1, 2010 Reviewed). Diagnosis of Tuberculous Disease. Available online at http://www.cdc.gov/tb/publications/factsheets/testing/diagnosis.htm. Accessed January 2011.

Centers for Disease Control and Prevention. Updated Guidelines for the use of Nucleic Acid Amplification Tests in the Diagnosis of Tuberculosis. MMWR January 16, 2009 / 58(01); 7-10.  Available online at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5801a3.htm?s_cid=mm5801a3_e. Accessed January 2011.

Herchline, T (December 17, 2010). Tuberculosis. eMedicine article. Available online at http://emedicine.medscape.com/article/230802-overview. Accessed January 2011.

(Jan. 29, 2009) Mayo Clinic. Tuberculosis. Available online at http://www.mayoclinic.com/health/tuberculosis/DS00372. Accessed January 2011.

(November 12, 2010) National Institute of Allergy and Infectious Diseases. Tuberculosis (TB). Available online at http://www.niaid.nih.gov/topics/tuberculosis/Pages/default.aspx. Accessed January 2011.

(November 2010) World Health Organization. Tuberculosis Fact Sheet. Available online at http://www.who.int/mediacentre/factsheets/fs104/en/index.html. Accessed January 2011.

Boehme C, et. al. Rapid Molecular Detection of Tuberculosis and Rifampin Resistance. N Engl J Med 2010; 363:1005-1015. Available online at http://www.nejm.org/doi/full/10.1056/NEJMoa0907847. Accessed January 2011.

Minion J, Leung E, Menzies D, Pai M. Microscopic-observation drug susceptibility and thin layer agar assays for the detection of drug resistant tuberculosis: a systematic review and meta-analysis. Lancet Inf Dis, 2010 Oct;10(10):688-98. Epub 2010 Aug 31. Available online at http://www.ncbi.nlm.nih.gov/pubmed/20813587. Accessed January 2011.

Herchline, T. and Amorosa, J. (Updated 2014 June 9). Tuberculosis. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/230802-overview. Accessed August 2014.

(© 1995–2014). Acid-Fast Smear for Mycobacterium. Mayo Clinic Mayo Medical Laboratories [On-line information]. Available online at http://www.mayomedicallaboratories.com/test-catalog/Overview/8213. Accessed August 2014.

Koirala, J. (Updated 2014 March 14). Mycobacterium Avium-Intracellulare. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/222664-overview. Accessed May 2014.

Zieve, D. (Updated 2013 November 20). Acid-fast stain. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003766.htm. Accessed August 2014.

(Updated 2014 May). Mycobacterium tuberculosis – TB. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/TB.html. Accessed August 2014.

Dugdale, D. (Updated 2011 December 6). Sputum stain for mycobacteria. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003724.htm. Accessed August 2014.

Pagana, K. D. & Pagana, T. J. (© 2011). Mosby's Diagnostic and Laboratory Test Reference 10th Edition: Mosby, Inc., Saint Louis, MO. Pp 983-984.

Availability of an Assay for Detecting Mycobacterium tuberculosis, Including Rifampin-Resistant Strains, and Considerations for Its Use — United States, 2013. Morbidity and Mortality Weekly Report October 18, 2013 / 62(41);821-824. Available online at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6241a1.htm?s_cid=mm6241a1_e. Accessed Sept 2014.

Food and Drug Administrations News Release: FDA permits marketing of first U.S. test labeled for simultaneous detection of tuberculosis bacteria and resistance to the antibiotic rifampin. July 25, 2013. Available online http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm362602.htm. Accessed September 2014.

(February 11, 2014) Centers for Disease Control and Prevention. A New Tool to Diagnose Tuberculosis: The Xpert MTB/RIF Assay. Available online at http://www.cdc.gov/tb/publications/factsheets/testing/Xpert_MTB-RIF.htm. Accessed September 2014.

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