Test Catalog

Test Id : CATTR

Cold Agglutinin Titer, Serum

Useful For
Suggests clinical disorders or settings where the test may be helpful

Detection of cold agglutinins in patients with suspected cold agglutinin disease


This test is not recommended to diagnose Mycoplasma pneumoniae infections.

Method Name
A short description of the method used to perform the test

Titration/Red Cell Agglutination

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.


Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Cold Agglutinin Titer

Specimen Type
Describes the specimen type validated for testing

Serum Red

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
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

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 degrees C prior to and after collecting.

2. Allow specimen to clot at 37 degrees C.

3. Centrifuge at 37 degrees 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.


If not ordering electronically, complete, print, and send an Benign Hematology Test Request (T755) with the specimen.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

1 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis OK
Gross icterus OK

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Serum Red Refrigerated (preferred) 7 days
Frozen 7 days
Ambient 72 hours

Useful For
Suggests clinical disorders or settings where the test may be helpful

Detection of cold agglutinins in patients with suspected cold agglutinin disease


This test is not recommended to diagnose Mycoplasma pneumoniae infections.

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

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
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Titer results:

>64: Elevated

>1000: May be indicative of hemolytic anemia

Provides information to assist in interpretation of the test results

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.

Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Clinical Reference
Recommendations for in-depth reading of a clinical nature

Cohn CS, Delaney M, Johnson ST, Katz LM, eds: Technical Manual. 20th ed. AABB; 2020

Method Description
Describes how the test is performed and provides a method-specific reference

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 degrees 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)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information


Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Friday, Sunday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

1 to 3 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

14 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test


Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.


LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
CATTR Cold Agglutinin Titer 14658-9
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
CATTR Cold Agglutinin Titer 14658-9

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports

Test Update Resources

Change Type Effective Date
New Test 2022-06-01