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Anaphylactic reactions are excluded by the presence of red plasma or urine, discordant pretransfusion and posttransfusion ABO blood types, or a positive direct antiglobulin (Coombs) test result. Demonstration of anti-IgA in a pretransfusion sample of the recipient's serum or plasma establishes the diagnosis.
A urine sample can be collected by the patient themselves, typically by urinating into a sterile container, a process called a clean catch.. Typically, the patient is asked to start urinating, and then once the stream has started and the first few seconds of flow have been discarded, the sample is collected.