A 13-year-old girl with juvenile rheumatoid arthritis presented for a routine examination. Except for a short episode of a cough 1 week prior, she had no complaints. The chest examination was normal. Blood cell count was performed on an automated analyzer using an ethylenediaminetetraacetic acid (EDTA) blood specimen and showed normal hemoglobin and leukocytes (7.2 X 10~9/L), but a mild thrombocytosis (467 X 10~9/L). Platelet clumps were flagged by the cell counter. However, when the peripheral smear was reviewed, there was leukocyte agglutination (shown, left) rather than clumps of platelets. The cold agglutinin test was positive with relative anti-I specificity. Serology for Mycoplasma pneumoniae was positive (complement fixation test 1:32, reference value <= 1:16; microparticles agglutination 1:1280, reference value <= 1:40). When the blood was warmed at 37癈, the smear no longer showed leukoagglutination (shown, right).
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机译：一名13岁的青少年类风湿性关节炎女孩接受常规检查。除了1周前的一小段咳嗽外，她没有任何不适。胸部检查正常。在自动分析仪上使用乙二胺四乙酸（EDTA）血液标本进行血细胞计数，显示正常的血红蛋白和白细胞（7.2 X 10〜9 / L），但轻度的血小板增多症（467 X 10〜9 / L）。细胞计数器标记血小板团块。但是，当检查外周涂片时，出现了白细胞凝集（如图所示，左）而不是血小板团块。冷凝集素测试呈阳性，具有相对的抗I特异性。肺炎支原体的血清学呈阳性（补体固定试验为1:32，参考值<= 1:16;微粒凝集为1：1280，参考值<= 1:40）。当血液温度升至37℃时，涂片不再显示白细胞凝集（如图所示）。
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