Kältereaktive Autoantikörper: Perioperatives Management

Zusammenfassung

Kältereaktive Autoantikörper binden bei niedrigen Temperaturen an Erythrozyten und agglutinieren diese. Sie sind, typisch für Autoantikörper, gegen ubiquitär vorhandene Antigene gerichtet und agglutinieren somit nicht nur die autologen Erythrozyten, sondern auch die fast aller Spender. Bei nahezu jedem Menschen sollen bei 0°C Autoantikörper mit niedrigem Titer nachweisbar sein, bei kaum einem fallen sie jedoch auf, da sie schon bei Temperaturen wenig höher als 0°C nicht mehr reaktiv sind und somit weder Symptome verursachen noch bei der immunhämatologischen Routinediagnostik in Erscheinung treten. Nur bei wenigen Patienten verursachen kältereaktive Autoantikörper die Kälteagglutininkrankheit mit Symptomen wie Hämolyse oder Akrozyanose. Diese Patienten bedürfen bei Krankenhausaufenthalten besonderer Aufmerksamkeit und individuell angepasster Prozeduren für die Labordiagnostik oder im Rahmen chirurgischer Eingriffe.

Abstract

Cold-reactive autoantibodies agglutinate red cells at low temperatures. Typical of autoantibodies, they are directed against ubiquitous antigens and therefore agglutinate not only autologous red cells, but also those of almost all donors. Autoantibodies with a low titre are detectable at 0°C in almost every person. In most cases, they are no longer reactive at temperatures a few degrees above 0°C and therefore neither cause symptoms nor do they appear in routine immunohaematological diagnostics. Only in a few patients do cold-reactive autoantibodies cause cold agglutinin disease with symptoms such as haemolysis or acrocyanosis. These patients require special attention during hospitalisation and individually adapted procedures for laboratory diagnostics or for surgical interventions.

Schlüsselwörter

Kältereaktive Autoantikörper - Chirurgie in Hypothermie - Hämolyse

Keywords

Cold-reactive autoantibodies - Surgery in hypothermia - Haemolysis

Publication History

Article published online:
14 May 2025

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