What is best practice for performing a CBC on a patient with a severe cold agglutinin?  Currently we have a patient who requires saline replacement with warmed saline to obtain results.  The typical saline replacement calculations do not work because of the agglutinated RBC's. Any suggestions?

(Not sure what you mean by "typical saline replacement calculations").  If the warm saline replacement works, we use the RBC, Hct and indices from the replacement results.  If it doesn't work because of a particularly stubborn CA, then we would not report out those results at all with a comment about the CAs causing interference.

Scott