Cold Agglutinins

Abbrev Code:COLD   
Order Code:LAB849Order Name:Cold AgglutininTiter
Synonyms:Hemagglutinin Titer, Cold
CPT Codes: 86157 x1
Turnaround Time:Specimens are sent to reference laboratory Mon-Sat; results are reported in 7 days.

Collection Instructions

Optimal Volume:2 mL
Minimum\Peds Volume:0.7 mL
Container:Red (no gel). Keep warm at 37 degree C using hot pack
Collection Instructions:Place specimen into 37°C water and deliver to laboratory immediately. Red or gold (gel) is also acceptable if kept at 37 degrees Celsius.
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.
Stability:After separation from cells: 48 hours at room temperature; 2 weeks refrigerated; 1 year frozen.
Test Performed at or Referral Lab Lab Sendouts  (ARUP)
Referral Lab number:50175


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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