Cryoglobulins

Specimen:

10 mL blood collected in a plain tube, separated at 37°C and then transported to the laboratory.

Method:

Serum is stored at 4°C for 72 h and inspected for precipitate during this period.

Precipitates may be quantitated and evaluated for monoclonal, polyclonal and mixed immunoglobulin components.

Electrophoresis should be carried out on redissolved cryoglobulin to detect any monoclonal components.

A plasma sample may also be collected at the same time under the same circumstances to assess for cryofibrinogen (precipitate present in the plasma, but not the serum).

Application:

Investigation of cold related symptoms, suspected immune complex mediated disease and Vasculitis. The disorder should be considered in the presence of one or more of renal impairment, rash and peripheral Neuropathy.

Interpretation:

A cryoglobulin precipitates at 4°C and redissolves at 37°C.

The presence of cryoglobulin may be secondary to an underlying infection (especially Hepatitis C virus infection), lymphoma, myeloma or immune complex disorder (eg, Sjogren's syndrome).

Reference:

Ferri C et al. J Clin Pathol 2002; 55(1): 4-13.

Michaud M, Pourrat J. J Clin Rheumatol 2013; 19(3): 142-148.