In response to the letter of Birrow, Cable, and Klein, we find little basis to their belief that insufficient evidence was provided in our case report to implicate autocold agglutinin hemolysis.We agree that monospecific Coombs' sera were not used. However, the monospecific anti-γ-globulin was not commercially available to our hospital's laboratory in 1973.The patient was first tested on Sept 27, 1973, and a routine antibody screening and direct Coombs' test were performed. The direct Coombs' test was positive ( + 2). The antibody screening was strongly positive at room temperature and decreasing toward the antihuman globulin phase of testing. The patient's cells gave very grainy reactions in the typing, and the proper typings were performed on washed cells from a heparinized sample. Since the antibody screening decreased in strength, another sample was collected and clotted at 4 °C in attempts of absorbing out auto-cold antibody. After one
Turtzo DF, Alpaugh K, Ghatak PK. Hemolytic Anemia With Mycoplasma Pneumoniae Pneumonia-Reply. JAMA. 1977;238(8):854–855. doi:10.1001/jama.1977.03280090018009
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