Cold Agglutinins
Ordering Recommendation
Semi-Quantitative Hemagglutination
Tue, Thu, Sat
2-7 days
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
Serum separator tube or plain red. 
Specimen Preparation
Keep in warm water (37°C) until processed for transport by laboratory; refrigeration of specimen before separation of serum from cells will adversely affect test results. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.25 mL) 
Storage/Transport Temperature
Unacceptable Conditions
Plasma or CSF. Refrigerated whole blood. Contaminated, severely hemolyzed, or lipemic, specimens. 
After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles) 
Reference Interval
< 1:32 Negative
Interpretive Data
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 37°C, 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 fourfold 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.

Hotline History
Component Test Code*Component Chart NameLOINC
0050175Cold Agglutinins5098-9
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please view this test within the Laboratory Test Directory found at
  • Cold Agglutinin Titer
  • Febrile Agglutinins