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22485 Cryoglobulin

Cryoglobulin
Test Code: CRYO
Synonyms/Keywords
Cryoglobulin in blood​
Useful For
This test is useful for determining cryoglobulinemia.  Cryoglobulins are immunoglobulins which are altered in some process that makes them insoluble to varying degrees at temperatures below 37°C​
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
No​ Serum​ Red Top Tubes (RTT)​
Citrated Blue
Top Tubes
(BTT) - only for "All Other Facilities" that do not have a 37°C waterbath​
 10 mL serum or 10 mL plasma​ 5 mL serum or 5 mL plasma​ 5 mL serum or 5 mL plasma​
Collection Processing Instructions
Draw Five - 6 mL Red Top Tubes (RTT).  Keep blood at 37°C (98.6° F) for at least 30 minutes, centrifuge for 5 minutes, and remove serum immediately.   Refrigerate.
For "All Other Facilities" that do not have a 37°C water bath, Eight - 2.7 mL Citrated Blue Top Tubes (BTT) may be drawn and centrifuged immediately.  Remove plasma immediately.
 
At Marshfield: Specimen may be collected at any time using the following procedure:
1. Obtain a heated thermos container from incubator.
2. Place tubes in thermos immediately after drawing and cover.
3. Send to Specimen Processing via tube system.  Specimen Processing must carry thermos to Special Chemistry immediately (after hours, place specimen in 37 °C water bath in Special Chemistry). Specimen must remain in the water bath until it is processed by Special Chemistry personnel.
4. Return the thermos for future use.​
Specimen Stability Information
Specimen Type Temperature Time
Serum​ Refrigerated (once sample is centrifuged and serum is taken off)​ 7days​
Plasma ("All Other Facilities" without 37°C water bath only)​ Refrigerated (once sample is centrifuged, and plasma is taken off)​ 7days​
Rejection Criteria
​Samples collected in Serum Separator Tubes (SST)
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield​ Monday through Friday​

4 days

If immunofixation is required, results may be delayed​

 Cold precipitation, and if positive, Immunofixation​
Test Information
This test was developed and its performance characteristics determined by Marshfield Labs.  It has not been cleared or approved by the US Food and Drug Administration.  This test is used for clinical purposes.  It should not be regarded as investigational or for research.
 
After serum is removed from cells, it is incubated at 2-8°C for 72 hours.  It is then centrifuged at 2-8°C and examined for the presence of precipitate.  Semi-quantitation is performed when precipitate is present.  Immunofixation is performed on the precipitate if it is > or = 0.4% of the total volume.​
 
If immunofixation is required, it will be charged separately.
Reference Range Information
Performing Location Reference Range
Marshfield​

Negative

If Positive - interpretation, typing and quantitation are provided.​

Interpretation

Cryogolbulins are common in plasma cell myelomas, but are also found in association with other neoplasms (lymphosarcoma, chronic lymphocytic leukemia, and carcinomatosis), in infectious diseases (hepatitis C, kala-azar, Sjogren's syndrome, subacute bacterial endocarditis, and malarias), in various systemic diseases (rheumatoid arthritis, periarteritis nodosa, and disseminated lupus erythematosus), and in miscellaneous disorders (myeloproliferative disorders and portal cirrhosis). An “essential" form of cryoglobulinemia has been described which does not appear to be associated with a specific disease state.

Clinically, cryoglobulinemia may present with features of Raynaud's syndrome – intolerance to cold, purpura, gangrene of the extremities, and skin sores. Death may result from blockage of key blood vessels in such vital organs as the kidneys, brain, and lungs. The specific symptoms depend on the amount present and the degree of anti-inflammatory response of the body.​

Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
82595​ ​ ​ ​ ​
​86334 ​ ​ ​Immunofixation (if needed) ​
Classification
This test was developed and its performance characteristics determined by Marshfield Labs.  It has not been cleared or approved by the US Food and Drug Administration.  This test is used for clinical purposes.  It should not be regarded as investigational or for research.
Synonyms/Keywords
Cryoglobulin in blood​
Ordering Applications
Ordering Application Description
​Centricity ​Cryoglobulin
​Cerner ​Cryoglobulin
​COM ​Cryoglobulin
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
No​ Serum​ Red Top Tubes (RTT)​
Citrated Blue
Top Tubes
(BTT) - only for "All Other Facilities" that do not have a 37°C waterbath​
 10 mL serum or 10 mL plasma​ 5 mL serum or 5 mL plasma​ 5 mL serum or 5 mL plasma​
Collection Processing
Draw Five - 6 mL Red Top Tubes (RTT).  Keep blood at 37°C (98.6° F) for at least 30 minutes, centrifuge for 5 minutes, and remove serum immediately.   Refrigerate.
For "All Other Facilities" that do not have a 37°C water bath, Eight - 2.7 mL Citrated Blue Top Tubes (BTT) may be drawn and centrifuged immediately.  Remove plasma immediately.
 
At Marshfield: Specimen may be collected at any time using the following procedure:
1. Obtain a heated thermos container from incubator.
2. Place tubes in thermos immediately after drawing and cover.
3. Send to Specimen Processing via tube system.  Specimen Processing must carry thermos to Special Chemistry immediately (after hours, place specimen in 37 °C water bath in Special Chemistry). Specimen must remain in the water bath until it is processed by Special Chemistry personnel.
4. Return the thermos for future use.​
Specimen Stability Information
Specimen Type Temperature Time
Serum​ Refrigerated (once sample is centrifuged and serum is taken off)​ 7days​
Plasma ("All Other Facilities" without 37°C water bath only)​ Refrigerated (once sample is centrifuged, and plasma is taken off)​ 7days​
Rejection Criteria
​Samples collected in Serum Separator Tubes (SST)
Useful For
This test is useful for determining cryoglobulinemia.  Cryoglobulins are immunoglobulins which are altered in some process that makes them insoluble to varying degrees at temperatures below 37°C​
Reference Range Information
Performing Location Reference Range
Marshfield​

Negative

If Positive - interpretation, typing and quantitation are provided.​

Interpretation

Cryogolbulins are common in plasma cell myelomas, but are also found in association with other neoplasms (lymphosarcoma, chronic lymphocytic leukemia, and carcinomatosis), in infectious diseases (hepatitis C, kala-azar, Sjogren's syndrome, subacute bacterial endocarditis, and malarias), in various systemic diseases (rheumatoid arthritis, periarteritis nodosa, and disseminated lupus erythematosus), and in miscellaneous disorders (myeloproliferative disorders and portal cirrhosis). An “essential" form of cryoglobulinemia has been described which does not appear to be associated with a specific disease state.

Clinically, cryoglobulinemia may present with features of Raynaud's syndrome – intolerance to cold, purpura, gangrene of the extremities, and skin sores. Death may result from blockage of key blood vessels in such vital organs as the kidneys, brain, and lungs. The specific symptoms depend on the amount present and the degree of anti-inflammatory response of the body.​

For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield​ Monday through Friday​

4 days

If immunofixation is required, results may be delayed​

 Cold precipitation, and if positive, Immunofixation​
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
82595​ ​ ​ ​ ​
​86334 ​ ​ ​Immunofixation (if needed) ​
Classification
This test was developed and its performance characteristics determined by Marshfield Labs.  It has not been cleared or approved by the US Food and Drug Administration.  This test is used for clinical purposes.  It should not be regarded as investigational or for research.
For most current information refer to the Marshfield Laboratory online reference manual.