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HelpMayo Test ID CATTR Cold Agglutinin Titer, Serum
Ordering Guidance
The cold agglutinin test is not specific for Mycoplasma pneumoniae and is not recommended to diagnose M pneumoniae infections. To diagnose M pneumoniae infections, order MPRP / Mycoplasmoides pneumoniae, Molecular Detection, PCR, Varies. For screening recent or past exposure to M pneumoniae, order MYCO / Mycoplasma pneumoniae Antibodies, IgG and IgM, Serum.
Specimen Required
Collection Container/Tube: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 4 mL
Pediatric Volume: 1 mL
Collections Instructions:
1. Use a warm pack to keep specimen at 37° C prior to and after collecting.
2. Allow specimen to clot at 37° C.
3. Centrifuge at 37° C and aliquot serum into plastic vial immediately after blood clots or within one hour of collection.
4. Do not refrigerate prior to separation of serum from red cells.
Useful For
Detection of cold agglutinins in patients with suspected cold agglutinin disease
This test is not recommended to diagnose Mycoplasma pneumoniae infections.
Method Name
Titration/Red Cell Agglutination
Reporting Name
Cold Agglutinin TiterSpecimen Type
Serum RedSpecimen Minimum Volume
1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum Red | Refrigerated (preferred) | 7 days | |
| Frozen | 7 days | ||
| Ambient | 72 hours |
Reject Due To
| Gross hemolysis | OK |
| Gross icterus | OK |
Clinical Information
The cold agglutinin titer test is to be used as a tool in the evaluation of suspected cold agglutinin syndrome. In this syndrome, cold agglutinins, usually IgM with anti-I specificity, attach to the patient's erythrocytes causing a variety of symptoms. Symptoms may include chronic anemia due to premature removal of the sensitized erythrocytes from circulation by hemolysis, to acrocyanosis of the ears, fingers, or toes due to local blood stasis in the skin capillaries.
Reference Values
Titer results:
>64: Elevated
>1000: May be indicative of hemolytic anemia
Interpretation
Titers above 64 are considered elevated, but hemolytic anemia resulting from cold-reactive autoagglutinins rarely occurs unless the titer is 1000 or above. Titers below 1000 may be obtained when the autoantibody has a different specificity (eg, anti-i) or if the cold agglutinin is of the less-common low-titer, high-thermal-amplitude type.
The test is not a direct measure of clinical significance and must be used in conjunction with other in vitro and in vivo parameters.
Clinical Reference
Cohn CS, Delaney M, Johnson ST, Katz LM, eds: Technical Manual. 20th ed. AABB; 2020
Method Description
The titer is determined by making serial doubling dilutions of the patient's serum in 0.9% saline. Group O indicator red cells are added, and the serum-cell mixture is then incubated 60 to 120 minutes at 2 to 8° C. The titer end point range is determined by hemagglutination.(Cohn CS, Delaney M, Johnson ST, Katz LM, eds: Technical Manual. 20th ed. AABB; 2020)
Day(s) Performed
Monday through Friday, Sunday
Report Available
1 to 3 daysSpecimen Retention Time
14 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
86157
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| CATTR | Cold Agglutinin Titer | 14658-9 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| CATTR | Cold Agglutinin Titer | In Process |