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Test ID CRY_S Cryoglobulin, Serum

Useful For

Evaluating patients with vasculitis, glomerulonephritis, and lymphoproliferative diseases

 

Evaluating patients with macroglobulinemia or myeloma in whom symptoms occur with cold exposure

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
IMFXC Immunofixation Cryoglobulin No No

Testing Algorithm

If cryoglobulin has a result other than negative, then iImmunofixation will be performed at an additional charge. Positive cryoglobulins of ≥0.1 mL of precipitate will be typed once.

Method Name

CRY_S: Quantitation and Qualitative Typing Precipitation at 1 Degree C.
Orderable as part of a panel or as a stand alone test. For further information see CRGSP / Cryoglobulin and Cryofibrinogen Panel, Serum and Plasma.

IMFXC: Immunofixation

Reporting Name

Cryoglobulin, S

Specimen Type

Serum

Collection Container/Tube: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 5 mL

Collection Instructions:

1. Tube must remain at 37° C.

2. Allow blood to clot at 37° C.

3. Centrifuge at 37° C. (Do not use a refrigerated centrifuge. If absolutely necessary, ambient temperature is acceptable.) It is very important that the specimen remain at 37° C until after separation of serum from red cells.

4. Place serum into an appropriately labeled plastic vial.

Additional Information: Analysis cannot be performed with <3 mL of serum. Smaller volumes are insufficient to detect clinically important trace (mixed) cryoglobulins. Less than 3 mL will require draw of a new specimen.

Specimen Minimum Volume

3 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Refrigerated (preferred)
  Frozen 

Clinical Information

Cryoglobulins are immunoglobulins that precipitate when cooled and dissolve when heated. Because these proteins precipitate when cooled, patients may experience symptoms when exposed to the cold. Cryoglobulins may be associated with a variety of diseases including plasma cell disorders, autoimmune diseases, and infections. Cryoglobulins may also cause erroneous results with some automated hematology instruments.

 

Cryoglobulins are classified as:

-Type I (monoclonal)

-Type II (mixed--2 or more immunoglobulins of which 1 is monoclonal)

-Type III (polyclonal--in which no monoclonal protein is found)

 

Type I cryoglobulinemia is associated with monoclonal gammopathy of undetermined significance, macroglobulinemia, or multiple myeloma.

 

Type II cryoglobulinemia is associated with autoimmune disorders such as vasculitis, glomerulonephritis, systemic lupus erythematosus, rheumatoid arthritis, and Sjogren's syndrome. It may be seen in infections such as hepatitis, infectious mononucleosis, cytomegalovirus, and toxoplasmosis. Type II cryoglobulinemia may also be essential, ie, occurring in the absence of underlying disease.

 

Type III cryoglobulinemia usually demonstrates trace levels of cryoprecipitate, may take up to 7 days to appear, and is associated with the same disease spectrum as Type II cryoglobulinemia.

Reference Values

Negative (positives reported as percent) 

Cautions

Failure to follow specimen handling instructions may cause false-negative results.

 

Not useful for general screening of a population without a clinical suspicion of cryoglobulinemia.

Day(s) Performed

Monday through Friday; 4 pm

Report Available

2 days

Performing Laboratory

Mayo Medical Laboratories in Rochester

Test Classification

This test uses a standard method. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

82595

NY State Approved

Yes