Lab Dept:

Chemistry

Test Name:

CRYOGLOBULIN, PLASMA AND SERUM

General Information

Lab Order Codes:

CRGL

Synonyms:

Cryofibrinogen; Cryoprecipitates; Cryoprotein

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.

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: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 Container and Collection. Requires both EDTA plasma and serum.

Specimen

Specimen Type:

Blood

Container:

Red top (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 (37ºC Water Bath or Heel Warmer) and deliver to laboratory immediately. Mix lavender top tube by gentle inversion. The serum tube must clot at 37ºC for 30 to 60 minutes before processing.

 

Special Processing:

Lab Staff:

Red top NO GEL - Maintain the specimen at 37ºC in a water bath until clotted. Allow specimen to clot for 30 to 60 minutes. If the specimen has not been maintained at 37ºC from the time of collection, allow the specimen to clot in 37ºC water bath for 3 hours. Centrifuge at 37ºC. Remove serum and aliquot into a plastic tube and store in refrigerator. Label specimen as serum sample. Ship at refrigerated temperatures.

Lavender top NO GEL - Maintain the specimen at 37ºC 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 37ºC prior to processing or gross hemolysis; mislabeled or unlabeled specimens; specimens collected in gel tubes; gross hemolysis; gross lipemia; grossly icteric; less than the amount of serum/plasma specified above

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:

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.

Methodology:

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

References:

Mayo Medical Laboratory April 2016

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.