Agglutination - Revision history

John at 13:50, 4 April 2023

2023-04-04T13:50:04Z

← Older revision		Revision as of 15:50, 4 April 2023
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	<gallery widths="250px" heights="250px" >		<gallery widths="250px" heights="250px" >
	File:Agglutination1.jpg\|link={{filepath:~~Agglutination2~~.jpg}}		File:Agglutination1.jpg\|link={{filepath:Agglutination1.jpg}}
	</gallery>		</gallery>

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	<gallery widths="250px" heights="250px" >		<gallery widths="250px" heights="250px" >
	File:Agglutination2.jpg\|link={{filepath:~~Agglutination1~~.jpg}}		File:Agglutination2.jpg\|link={{filepath:Agglutination2.jpg}}
	</gallery>		</gallery>

John at 09:45, 24 March 2023

2023-03-24T09:45:27Z

← Older revision		Revision as of 11:45, 24 March 2023
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	<gallery widths="250px" heights="250px" >		<gallery widths="250px" heights="250px" >
	File:~~Agglutination2~~.jpg\|link={{filepath:Agglutination2.jpg}}		File:Agglutination1.jpg\|link={{filepath:Agglutination2.jpg}}
	</gallery>		</gallery>


	<span style="font-style:italic; font-size:90%;'' >		<span style="font-style:italic; font-size:90%;'' >
	'''''Clinical Image 1:''' ~~Several~~ irregular ~~groups~~ of cells ~~are shown, these are very different from the linear structures of rouleaux and~~ can be seen to ~~include dense damaged cells both within~~ the ~~agglutinates and circulating separately~~. Clinical condition: cold haemagglutinin disease (CHAD)''		'''Clinical Image 1:''' A low power image shows how the disease is first detected – the agglutinates cause a very irregular distribution of cells that on closer examination can be seen to comprise erythrocytes in irregular clumps. In severe cases these changes can be detected without the need for microscopy. Clinical condition: cold haemagglutinin disease (CHAD).
	</span>		</span>


	<gallery widths="250px" heights="250px" >		<gallery widths="250px" heights="250px" >
	File:~~Agglutination1~~.jpg\|link={{filepath:Agglutination1.jpg}}		File:Agglutination2.jpg\|link={{filepath:Agglutination1.jpg}}
	</gallery>		</gallery>


	<span style="font-style:italic; font-size:90%;'' >		<span style="font-style:italic; font-size:90%;'' >
	'''''Clinical Image 2:''' ~~A low power image shows how the disease is first detected – the agglutinates cause a very~~ irregular ~~distribution~~ of cells ~~that on closer examination~~ can be seen to ~~comprise erythrocytes in irregular clumps. In severe cases these changes can be detected without~~ the ~~need for microscopy~~. Clinical condition: cold haemagglutinin disease (CHAD).''		'''''Clinical Image 2:''' Several irregular groups of cells are shown, these are very different from the linear structures of rouleaux and can be seen to include dense damaged cells both within the agglutinates and circulating separately. Clinical condition: cold haemagglutinin disease (CHAD)''
	</span>		</span>

John at 09:43, 24 March 2023

2023-03-24T09:43:45Z

← Older revision		Revision as of 11:43, 24 March 2023
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	<span style="font-style:italic; font-size:90%;'' >		<span style="font-style:italic; font-size:90%;'' >
	'''Appearance:''' The key ~~points are~~ that the red cell ~~groups~~ are very irregular. In many cases they will include cells that have been damaged by the underlying immunological process (shown in the cartoon image as a spherocyte and irregularly contracted cell with the agglutinated group). A small image from a clinical case is shown for comparison.		'''Appearance:''' The key point is that the red cell form group that are very irregular rather than linear. In many cases they will include cells that have been damaged by the underlying immunological process causing agglutination (shown in the cartoon image as a spherocyte and irregularly contracted cell with the agglutinated group). A small image from a clinical case is shown for comparison, but note that agglutinates may be much bigger in many cases.
	</span>		</span>

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	'''Pitfalls'''		'''Pitfalls'''

	Be sure to examine at the correct part of the blood film since cells ~~can be grouped~~ in thicker parts of the blood film; also be careful to distinguish the appearance from rouleaux. If agglutination and rouleaux co-exist, then it is important to look for the much more irregular clumping that characterises agglutination. A specific cold-reactive IgG antibody (Donath Landsteiner antibody) causes the clinical disorder Paroxysmal Cold Haemoglobinuria (PCH). It is important to recognise this condition (see images).		Be sure to examine at the correct part of the blood film since cells often group together in thicker parts of the blood film - in true agglutination this effect will be seen within the normal viewing region of the film; also be careful to distinguish the appearance from rouleaux. If agglutination and rouleaux co-exist, then it is important to look for the much more irregular clumping that characterises agglutination. A specific cold-reactive IgG antibody (Donath Landsteiner antibody) causes the clinical disorder Paroxysmal Cold Haemoglobinuria (PCH). It is very important to recognise this condition which carries greater clinical significance (see images for associated features).

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John at 12:37, 23 March 2023

2023-03-23T12:37:26Z

← Older revision		Revision as of 14:37, 23 March 2023
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	'''Derivation:''' ''From latin “fasten with glue”''		'''Derivation:''' ''From latin “fasten with glue”''
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John at 18:36, 11 March 2023

2023-03-11T18:36:29Z

← Older revision		Revision as of 20:36, 11 March 2023
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	<gallery mode="nolines" widths="240px" heights="240px" border="1px" >		<gallery mode="nolines" widths="240px" heights="240px" border="1px" >
	File:RC_C_agglutination_G.png\|link={{filepath:RC_C_agglutination_G.png}}		File:RC_C_agglutination_G.png\|link={{filepath:RC_C_agglutination_G.png}}
	File:RC_F_Agglutination_G.jpg\|link={{filepath:~~RC_F_agglutination_G~~.jpg}}		File:RC_F_Agglutination_G.jpg\|link={{filepath:RC_F_Agglutination_G.jpg}}
	</gallery>		</gallery>

John at 18:32, 11 March 2023

2023-03-11T18:32:25Z

← Older revision		Revision as of 20:32, 11 March 2023
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	<gallery widths="250px" heights="250px" >		<gallery widths="250px" heights="250px" >
	File:Agglutination2.jpg\|link={{filepath:~~Agglutination1~~.jpg}}		File:Agglutination2.jpg\|link={{filepath:Agglutination2.jpg}}
	</gallery>		</gallery>

John at 18:31, 11 March 2023

2023-03-11T18:31:26Z

← Older revision		Revision as of 20:31, 11 March 2023
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	<gallery widths="250px" heights="250px" >		<gallery widths="250px" heights="250px" >
	File:Agglutination1.jpg\|link={{filepath:~~Agglutination2~~.jpg}}		File:Agglutination1.jpg\|link={{filepath:Agglutination1.jpg}}
	</gallery>		</gallery>

John at 11:46, 8 March 2023

2023-03-08T11:46:45Z

← Older revision		Revision as of 13:46, 8 March 2023
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	\|Bacterial: H.influenza, Mycoplasma pneumoniae		\|Bacterial: H.influenza, Mycoplasma pneumoniae
	\|-		\|-
	Chronic idiopathic		\|Chronic idiopathic
	\|-		\|-
	\|}		\|}

John at 11:46, 8 March 2023

2023-03-08T11:46:13Z

← Older revision		Revision as of 13:46, 8 March 2023
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	<div style="width: 95%; overflow: auto; border: 1px solid navy; font-size:~~100~~%">		<div style="width: 95%; overflow: auto; border: 1px solid navy; font-size:90%">
	{\| class="wikitable" style="color:black; background-color:#ffffff;" cellpadding="15"		{\| class="wikitable" style="color:black; background-color:#ffffff;" cellpadding="15"
	!colspan="1" \|'''Primary Causes'''		!colspan="1" \|'''Primary Causes'''
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	\|Viral: measles, mumps, influenza A, adenovirus, CMV, EBV and post-vaccination		\|Viral: measles, mumps, influenza A, adenovirus, CMV, EBV and post-vaccination
	\|-		\|-
	Bacterial: H.influenza, Mycoplasma pneumoniae		\|Bacterial: H.influenza, Mycoplasma pneumoniae
	\|-		\|-
	Chronic idiopathic		Chronic idiopathic

John at 14:37, 6 March 2023

2023-03-06T14:37:09Z

← Older revision		Revision as of 16:37, 6 March 2023
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	----		----



	~~<gallery mode="nolines" widths="240px" heights="240px" border="1px" >~~
	~~File:xxx.png\|link={{filepath:xxx.png}}~~
	~~File:yyy.jpg\|link={{filepath:yyy.jpg}}~~
	~~</gallery>~~


	~~<span style="font-style:italic; font-size:90%;'' >~~
	~~'''Appearance:'''~~
	~~(/span>~~

	~~----~~


	~~'''Significance'''~~

	Agglutinates arise when antibodies attach to antigens on the membranes of adjacent red cells linking them together. The most common cause is "cold-reactive" IgM antibodies which do not cause overt symptoms. However, in some cases the effects may be clinically significant since antibodies may activate complement causing haemolysis, or the agglutinated cells can cause occlusion of small blood vessels in the cold (acrocyanosis). The clumped cells will sediment more rapidly leading to a raised erythrocyte sedimentation rate (ESR). Finally, the antibodies that cause cold agglutination may indicate an underlying malignancy (particularly lymphoma), or by acute infection.



	~~'''Pitfalls'''~~

	Be sure to examine at the correct part of the blood film since cells can be grouped in thicker parts of the blood film; also be careful to distinguish the appearance from rouleaux. If agglutination and rouleaux co-exist, then it is important to look for the much more irregular clumping that characterises agglutination. A specific cold-reactive IgG antibody (Donath Landsteiner antibody) causes the clinical disorder Paroxysmal Cold Haemoglobinuria (PCH). It is important to recognise this condition (see images).

	~~----~~


	~~'''1. Causes'''~~



	~~<div style="width: 95%; overflow: auto; border: 1px solid navy; font-size:100%">~~
	~~{\| class="wikitable" style="color:black; background-color:#ffffff;" cellpadding="15"~~
	~~!colspan="1" \|'''Big Title'''~~
	\|-
	~~\|Information 1~~
	\|-
	~~!colspan="1"\| '''Big Title 2'''~~
	\|-
	~~\|Information 2~~
	\|-
	~~\|Information 2~~
	\|-
	~~\|Information 2~~
	\|-
	~~!colspan="1"\| '''Big title 3'''~~
	\|-
	~~\|Information 3~~
	\|-
	}
	~~</div>~~

	~~----~~


	~~'''Clinical Examples'''~~



	~~<gallery widths="250px" heights="250px" >~~
	~~File:aaa.jpg\|link={{filepath:aaa.jpg}}~~
	~~</gallery>~~


	~~<span style="font-style:italic; font-size:90%;'' >~~
	~~'''''Clinical Image 1:'''aaa''~~
	~~</span>~~