Cold Agglutinins


Sunquest Code:COLD  
Epic Code:LAB849Epic Name:Cold AgglutininTiter
Synonyms:Hemagglutinin Titer, Cold
Methodology:Hemaglutination
CPT Code:86157
Turnaround Time:Specimens are sent to reference laboratory Mon-Sat; results are reported in 7 days.


Collection Instructions

Specimen:Blood
Optimal Volume:2 mL
Minimum\Peds Volume:0.7 mL
Collection Instructions:Place specimen into 37 C water and deliver to laboratory immediately. Refrigeration of specimen before separation of serum from cells will adversely affect test results.
Causes for Rejection:CSF or plasma, gross hemolysis; gross lipemia; refrigerated whole blood.


Processing and Shipping

Specimen Processing:Allow specimen to clot at 37 C until processed. Centrifuge and aliquot 1 mL, 0.25 mL minimum. Store in refrigerator.
Shipping Instructions:Ship at refrigerated temperature.
Test Performed at or Referral Lab Lab Sendouts  (ARUP)
Referral Lab number:50175


Interpretive

Reference Range:Less than 1:32 negative Titers of 1:32 or higher are considered elevated by this technique. Elevated titers are rarely seen except in primary atypical pneumonia and in certain hemolytic anemias. If the agglutination is not reversible after incubation at 37C, then the reaction is not due to cold agglutinins. Primary atypical pneumonia can be caused by Mycoplasma pneumoniae, influenza A, influenza B parainfluenza and adenoviruses. However, a four-fold rise in the cold agglutinins usually begins to appear late in the first week or during the second week of the disease and begins to decrease between the fourth and sixth weeks. Low titers of cold agglutinins have been demonstrated in malaria, peripheral vascular disease, and common respiratory disease.


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