Clinics and Departments

Laboratory Services

Lab Dept:

Chemistry

Test Name:

CRYOGLOBULIN, PLASMA AND SERUM

General Information

Lab Order Codes:

CRGL

Synonyms:

Cryofibrinogen; Cryoprecipitates

CPT Codes:

82595 – Cryoglobulin, qualitative or semi quantitative
82585 – Cryofibrinogen
86334 - Immunofixation (if appropriate)

Test Includes:

Quantitation and qualitative typing, precipitation at 1 degree centigrade. Includes cryofibrinogen. If cryoglobulin has a result other than negative, Immunofixation will be performed at an additional charge. Positive cryoglobulins of ≥0.1 mL of precipitate will be typed once every 6 months.

Logistics

Test Indications:

Useful for evaluating patients with vasculitis, glomerulonephritis, lymphoproliferative disease. Cases of macroglobulinemia or myeloma in whom symptoms occur with cold exposure.

Lab Testing Sections:

Chemistry - Sendouts

Referred to:

Mayo Medical Laboratories (MML Test: 83659/CRGSP)

Phone Numbers:

MIN Lab: 612-813-6280

STP Lab: 651-220-6550

Test Availability:

Daily, 24 hours

Turnaround Time:

2 – 10 days, test set-up Monday – Friday.

Special Instructions:

See Collection

Specimen

Specimen Type:

Blood

Container:

Red top (plain, no gel) tube and Lavender top (EDTA, no gel) tubes

Note: Both tubes are required. Serum is used for cryoglobulin and plasma is used for cryofibrinogen.

Draw Volume:

Red top: 9 mL blood

Lavender top: 1.5 mL blood

Processed Volume:

Minimum: 3 mL serum and 0.5 plasma

Collection:

Routine venipuncture. Keep both specimens warm (37C Water Bath or Heel Warmer) and deliver to laboratory immediately. Mix lavender top tube by gentle inversion. The serum tube must clot at 37C for 30 to 60 minutes before processing.

Special Processing:

Lab Staff:

Red top - Maintain the specimen at 37C in a water bath until clotted. Allow specimen to clot for 30 to 60 minutes. If the specimen has not been maintained at 37C from the time of collection, allow the specimen to clot in 37C water bath for 3 hours. Centrifuge at 37C. Remove serum and aliquot into a plastic tube and store in refrigerator. Label specimen as serum sample. Ship at refrigerated temperatures.

Lavender top - Maintain the specimen at 37C including centrifugation. Remove plasma aliquot into a screw-capped round bottom plastic vial. Label as plasma sample. Store and ship at refrigerated temperatures.

Patient Preparation:

None

Sample Rejection:

Not maintained at 37C prior to processing or gross hemolysis; mislabeled or unlabeled specimens

Interpretive

Reference Range:

Cryoglobulin: Negative

Note: Positives will be reported as a percent. If positive after 1 or 7 days, immunotyping of the cryoprecipitate is performed at an additional charge.

Cyrofibrinogen: Negative

Note: Reported as positive or negative. Quantitation and immunotyping will not be performed on positive cryofibrinogen.

An interpretive report will be provided.

Critical Values:

None

Limitations:

The specimen must be collected at 37C and kept warm until separation of serum or plasma from red cells. Not useful for general screening of a population without a clinical suspicion of cryoglobulinemia.

Methodology:

Quantitation and Qualitative Typing, Precipitation at 1 degree C.
When indicated may include Immunofixation,

References:

Mayo Medical Laboratory Web Page (September 2010)

Updates:

3/4/2004:Test moved from Fairview Diagnostic Laboratory to MML. Test now includes both cryofibrinogen and cryoglobulin.
1/31/2007: MML has split out Immunofixation from this test and will only perform and charge for it with a positive cryoglobulin. Order code previously listed as 9052.
8/29/2007: Positive cryoglobulins of ≥0.1 mL of precipitate will be typed once every 6 months.
9/27/2010: Specimen volume updates.



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