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A B C D E F G H I J K L M N O P Q

Test Identifier Information

 
Registration CodeCRYP
Method

 

The normal proteins of plasma and serum do not precipitate in the cold.  An aliquot of plasma and serum are incubated for 72 hrs at 4 degrees C.  If a precipitate develops, the tube(s) are warmed to 37 degrees C to check that the precipitate redissolves, then incubated again at 4 degrees C to check precipitate reforms.  All positive cryoglobulins are identified by immunofixation.

Diagnostic Use / Indications

Cryoglobulins assesses both the presence of cryofibrinogen  (plasma tube) and cryoglobulins (serum tube). For this reason sending both plasma AND serum is most informative.

Cryoglobulins should be considered for assessing patients with vasculitis, glomerulonephritis and lymphoproliferative disease. Consideration may also be given to patients presenting with unexplained purpura or vascular manifestations.

Where symptoms of cold exposure exist and macroglobulinaemia or multiple myeloma have been identified, cryoglobulins should be tested.

External Price$90.34(Exclusive of GST)
  

Specimen Collection

 
Pre-Testing Requirements

Ensure vaccutainers and other blood sampling equipment is pre-warmed to 37°C. Equipment used for processing and separating samples should also be pre-warmed to 37°C to avoid cooling of the sample on contact and potential risk of precipitating out proteins of interest.

Specimen Collection Protocols

IF SAMPLES HAVE NOT BEEN SEPARATED THEY MUST BE KEPT AT 37°C

Ensure all sampling equipment and vaccutainers are pre-warmed to 37°C, before collecting 5 mL of blood into an EDTA tube (purple top) and 5 mL of blood into a plain tube (red top).

Stand tubes for 40 minutes at 37°C to ensure that the plain tube is fully clotted, before separating.

Centrifuge samples for 10 minutes in at 37°C, (DO NOT USE A REFRIDGERATED CENTRIFUGE, if absolutely necessary, ambient temperature is acceptable) then separate off the serum from the plain tube and transfer it into a tube labelled serum. Also separate off the plasma from the EDTA tube and label this plasma.

Once plasma and serum have been separated it is no longer necessary to retain these at 37°C.

Samples being sent to the laboratory for separation must be kept at 37°C. Using a thermos flask with sand heated to 37°C is presently the only suitable means of transferring these samples.

DO NOT refrigerate samples UNTIL they have been separated.

IF SAMPLES HAVE NOT BEEN SEPARATED

THEY MUST BE KEPT AT 37°c

Patient SpecimenBlood 5 mL EDTA Plus 5 mL Plain - must be kept at 37C.
  

Instructions for Referral to CHLabs

 
Aliquot InstructionsKeep tubes at 37C transfer to Lab (very important)Must be kept at 37C until separated.
Aliquot Transport to CHLMust be kept at 37C until separated.
  

CHLabs Laboratory

 
DepartmentBiochemistry - Protein Laboratory
Contact Details Email Email
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Contact Phone Number(03)3640334 | x80334
Test AvailabilityMonday to Friday. 8.00am - 3.30pm only.
Turnaround Time5 - 10 days
Reference Interval

Refer to Protein Chemistry Lab ext 80334

Interpretation

Cryoprecipitants may be identified as:

Cryofibrinogen: This is observed as a precipitant only in the plasma tube identified at 4°C. These are rare but may be associated with vasculitis.

Cryoglobulin: These are divided into three types:

Type I: These are purely monoclonal immunoglobulins, usually associated with MGUS, macroglobulinaemia or multiple myeloma.

Type II: These are a mixture of 2 or more immunoglobulins, of which at least one is monoclonal). This type is usually associated with autoimmune disorders, such as; vasculitis, glomerulonephritis, systemic lupus erythematosus, rheumatoid arthritis and Sjorgren's syndrome; infections, such as hepatitis, infectious mononucleosis, cytomegalovirus and toxoplasmosis. This condition may occur in the absence of any underlying disease.

Type III: These consist of one or more polclonal immunoglobulins. Generally these are present only in trace amounts. These are generally associated with the same conditions that Type II cryoglobulins are associated with.

Failure to identify cryoglobulins or cryofibrinogen may be due to failure to follow sample collection procedures. It is imperative that these are strictly adhered to.

Additional Information

Samples must be kept at 37°C until they are separated.

Delphic Number Test Number3216

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