Specimen Requirements


Cold Agglutinins

Specimen Requirement

1 Red Top/2.0 mL serum. Do not collect in serum separator tube. Place specimen in warm (37 c) water to clot. After 30 minutes of clotting, promptly centrifuge and separate serum.

Send serum in screw-capped plastic vial and indicate “serum/red top” on specimen.



Room Temperature 14 days; Refrigerated 28 days

Reference Range

By Report*


3-5 days Performed Mon, Wed, Fri

Clinical Use

Useful in supporting the diagnosis of primary atypical pneumonia, infection with Mycoplasma pneumoniae, and hemolytic anemia, gangrene, cirrhosis, Raynaud’s disease, some viral diseases, and infectious diseases such as staphylococcemia, influenza, and tuberculosis. Cold agglutinins can cause intravascular agglutination (acrocyanosis) or hemolysis (due to the fixing of complement) in the peripheral circulation, causing pain and discoloration of extremities upon exposure to cold. Primary (chronic) cold agglutinin syndrome (CAS) is typically due to the presence of kappa light chain monoclonal autoantibodies to erythrocytic polysaccharide antigens (e.g., I, i and Pr) related to the ABO and Lewis blood groups.

Test Code