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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

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

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