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Test Directory -  Cold Agglutinins


Cold Aggs

Clinical Indications

Measurement of the level of Anti I/i in samples from patients with suspected, or diagnosed, Cold Haemagglutinin Disease (CHAD). Requestors attempting to use this test for diagnosis of anything other than CHAD should be asked to contact Microbiology.

Request Form

Combined Pathology Blood form (Yellow/Black or Blue for GP's)


Request by or after discussion with Consultant Haematologist

Specific Criteria

On clinical indication only with guidance from Consultant Haematologist

Turnaround Time

72 - 96 Hours


Whole Blood Only


2 X 6 ml EDTA


Purple Top EDTA sample                              

Specific Collecting Conditions

Patients must be bled at Basildon Hospital. GP and outpatient requests can attend Monday to Thursday (9.00am to 4.30pm only) without having to book an appointment. For inpatients please contact Blood Transfusion to obtain a flask.
Take both samples into pre-warmed purple top (EDTA) tube immediately label, with patient details. Place in sample bag and place in flask containing 37°C water. Replace the flask lid. Take samples to the laboratory immediately.

Lab. Handling

Samples should remain warm until separation of plasma.

Causes for Rejection

Samples not collected using pre-warmed (37°C) collection tubes, not transported in pre-warmed flask or delay in samples reaching laboratory.


This test is not suitable as a surrogate test for Mycoplasma Pneumonia, Atypical Pneumonia, or Syphilis.
Samples that are not kept at the required temperature will give possible incorrect results.
A fourfold or greater rise in the titre of cold agglutinins is suggestive of a recent M.pneumoniae infection

Reference Range

Positive results at 1 in 64 or a higher dilution in the pooled adult cells may be indicative of Cold Haemaglutinin Disease. Antibody may be Anti-I, which gives a higher titre in the pooled adult cells, or Anti-i, which gives a higher titre in the pooled cord cells. Cold Haemaglutinin Disease would normally be accompanied by a positive Direct Antiglobulin Test showing C3 on the patient’s cells.

NOTE: This test is now referred and it is not part of our UKAS accreditation. 



Version 1.1 / December  2014