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Definition

Agglutinins are antibodies that cause the red blood cells to clump together.

  • Cold agglutinins are active at cold temperatures.
  • Febrile (warm) agglutinins are active at normal body temperatures.

This article discusses the blood test used to measure the level of these antibodies in the blood.

Alternative Names

Cold agglutinins; Weil-Felix reaction; Widal's test; Warm agglutinins

How the test is performed

Blood is drawn from a vein, usually from the inside of the elbow or the back of the hand. The site is cleaned with germ-killing medicine (antiseptic). The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood.

Next, the health care provider gently inserts a needle into the vein. The blood collects into an airtight vial or tube attached to the needle. (The tube is first warmed to normal body temperature - 98.6 degrees F). The elastic band is removed from your arm.

Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

In infants or young children, a sharp tool called a lancet may be used to puncture the skin and make it bleed. The blood collects into a small glass tube called a pipette, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding.

The sample is sent to a laboratory.

How to prepare for the test

There is no special preparation.

How the test will feel

When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

Why the test is performed

This test is done to diagnose certain infections and to determine the cause of hemolytic anemia. Distinguishing between warm and cold agglutinins can help understand why the hemolytic anemia is occurring and can direct therapy.

Normal Values
  • Warm agglutinins: no agglutination in titers at or below 1:80
  • Cold agglutinins: no agglutination in titers at or below 1:16

Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

What abnormal results mean

The presence of warm agglutinins may occur with:

The presence of cold agglutinins may occur with:

  • Infections, especially Mycoplasma pneumonia
  • Previous viral, staphylococcal, or malaria infection
  • Cancer, including lymphoma and multiple myeloma
  • Systemic lupus erythematosus
What the risks are

Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight but may include:

  • Excessive bleeding
  • Fainting or feeling light-headed
  • Hematoma (blood accumulating under the skin)
  • Infection (a slight risk any time the skin is broken)
Special considerations

If cold agglutinin disease is suspected, the individual needs to be kept warm.

References

Schwartz RS. Autoimmune and intravascular hemolytic anemias. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 164.

Baum SG. Mycoplasma infections. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 338.

Powers A, Silberstein LE. Autoimmune hemolytic anemia. In: Hoffman R, Benz EJ, Shattil SS, et al, eds. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 47.

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Related Questions

What does a cold agglutinins test confirm?

The cold agglutinins test is used to confirm the diagnosis of certain diseases that stimulate the body to produce cold agglutinins


What is the purpose of the febrile agglutinins test?

The febrile agglutinins test is used to confirm the diagonsis of certain infectious diseases that stimulate the body to produce febrile agglutinins.


Where are agglutinins found?

in the plasma


What are normal results on a Cold Agglutinins Test?

The results of the cold agglutinins test require a doctor's interpretation. In general, however, a normal value is lower than 1:32.


How are agglutinins like security guards?

As they are type of antibody they are known as securitygaurd


What are the similarities between agglutinogens and agglutinins?

Both found in blood and both part of the immune system.


What is associated with a cold agglutinins test?

disease most commonly diagnosed by this test is mycoplasmal pneumonia, but mononucleosis, mumps, measles, scarlet fever, some parasitic infections, cirrhosis of the liver, and some types of hemolytic anemia can also cause the formation of cold agglutinins


What is a cold agglutinins test?

There is a bedside version of the test in which the doctor collects four or five drops of blood in a small tube, cools the tube in ice water for 30-60 seconds, and looks for clumping of red blood cells.


What are fever evaluation tests?

Fever evaluation tests, better known as febrile agglutinins tests, are performed to detect the presence of antibodies in the blood that are sensitive to temperature changes.


What are abnormal results of a Cold Agglutinins Test?

Any value higher than 1:32 suggests a diagnosis of mycoplasmal pneumonia or one of the other viral infections or disease conditions indicated by this test.


What special handling does a cold agglutinins test require?

A cold agglutinins test requires special handling to prevent false results due to temperature sensitivity. Blood samples should be collected in a warm tube and kept at body temperature until they are processed, typically by using a heat block or incubator. Additionally, the sample should be tested promptly, ideally within a few hours, to minimize the effects of cold exposure that can lead to agglutination inappropriately. Proper labeling and immediate transport to the lab are also essential to ensure accurate results.


What is the difference between agglutinogens and agglutinin?

When the immune system cause cross linking of cells or particles an agglutination reaction occurs and the responsible antibody is an agglutininAgglutinogens are1. any substance that, acting as an antigen, stimulates the production of agglutinin.2. the particulate antigen used in conducting agglutination tests.