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Febrile/cold agglutinins
Cold agglutinins; Weil-Felix reaction; Widal test; Warm agglutinins; Agglutinins
Agglutinins are antibodies that cause the red blood cells to clump together.
Antibodies
An antibody is a protein produced by the body's immune system when it detects harmful substances, called antigens. Examples of antigens include micr...
- Cold agglutinins are active at cold temperatures.
- Febrile (warm) agglutinins are active at normal body temperatures.
This article describes the blood test that is used to measure the level of these antibodies in the blood.
How the Test is Performed
Blood sample is needed
Venipuncture is the collection of blood from a vein. It is most often done for laboratory testing.
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. Others feel only a prick or stinging. Afterward, there may be some throbbing where the needle was inserted.
Why the Test is Performed
This test is done to diagnose certain infections and find the cause of hemolytic anemia (a type of anemia that occurs when red blood cells are destroyed). Knowing whether there are warm or cold agglutinins can help explain why the hemolytic anemia is occurring and direct treatment.
Hemolytic anemia
Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. Normally, red ...
Normal Results
Normal results are:
- Warm agglutinins: no agglutination in titers at or below 1:80
- Cold agglutinins: no agglutination in titers at or below 1:16
The examples above are common measurements for results of these tests. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your doctor about the meaning of your specific test results.
What Abnormal Results Mean
An abnormal (positive) result means there were agglutinins in your blood sample.
Warm agglutinins may occur with:
-
Infections, including
brucellosis
,
rickettsial disease
,
salmonella infection
, and
tularemia
Brucellosis
Brucellosis is an infectious disease that occurs from contact with animals carrying brucella bacteria.
ImageRead Article Now Book Mark ArticleRickettsial disease
Q fever is an infectious disease that is spread by domestic and wild animals and ticks.
Read Article Now Book Mark ArticleSalmonella infection
Salmonella enterocolitis is an infection in the lining of the small intestine that is caused by salmonella bacteria. It is a type of food poisoning....
ImageRead Article Now Book Mark ArticleTularemia
Tularemia is a bacterial infection common in wild rodents. The bacteria are passed to humans through contact with tissue from the infected animal. ...
ImageRead Article Now Book Mark Article - Inflammatory bowel disease
- Lymphoma
- Systemic lupus erythematosus
- Use of certain medicines, including methyldopa, penicillin, and quinidine
Cold agglutinins may occur with:
- Infections, especially mononucleous and mycoplasma pneumonia
- Chicken pox (varicella)
- Cytomegalovirus infection
-
Cancer, including lymphoma and
multiple myeloma
Multiple myeloma
Multiple myeloma is a blood cancer that starts in the plasma cells in the bone marrow. Bone marrow is the soft, spongy tissue found inside most bone...
ImageRead Article Now Book Mark Article - Listeria monocytogenes
- Systemic lupus erythematosus
- Waldenström macrogolulinemia
Risks
Risks are slight but may include:
- Excessive bleeding
-
Fainting
or feeling lightheaded
Fainting
Fainting is a brief loss of consciousness due to a drop in blood flow to the brain. The episode most often lasts less than a couple of minutes and y...
Read Article Now Book Mark Article - Hematoma (blood accumulating under the skin)
- Infection (a slight risk any time the skin is broken)
Considerations
If a disease linked to cold agglutinin is suspected, the person needs to be kept warm.
References
Baum SG. Mycoplasma infections. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 317.
Jäger U, Lechner K. Autoimmune hemolytic anemia. In: Hoffman R, Benz EJ Jr, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice . 6th ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 44.
Michel M. Autoimmune and intravascular hemolytic anemias. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 160.
-
Blood test - illustration
Blood is drawn from a vein (venipuncture), usually from the inside of the elbow or the back of the hand. A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. Preparation may vary depending on the specific test.
Blood test
illustration
-
Blood test - illustration
Blood is drawn from a vein (venipuncture), usually from the inside of the elbow or the back of the hand. A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. Preparation may vary depending on the specific test.
Blood test
illustration
Review Date: 5/11/2016
Reviewed By: Subodh K. Lal, MD, gastroenterologist with Gastrointestinal Specialists of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
