Cryoglobulins Serum

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No Fasting Required

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Detects cryoglobulin proteins.

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Cryoglobulins Serum - Comprehensive Medical Test Guide

Why is it done?
- Detects abnormal immunoglobulins (antibodies) that precipitate at cold temperatures and dissolve upon rewarming, indicating the presence of cryoglobulins in the blood
- Diagnoses cryoglobulinemia, a condition where abnormal proteins form immune complexes that can cause inflammation and tissue damage
- Ordered when patients present with symptoms such as purpura (skin discoloration), arthralgia (joint pain), peripheral neuropathy, or recurrent infections
- Investigates patients with Hepatitis C virus (HCV) infection, as HCV-associated cryoglobulinemia is one of the most common forms
- Evaluates autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus (SLE), or Sjögren's syndrome
- Monitors patients with known cryoglobulinemia to assess disease activity and treatment response
- Typically performed when unexplained vasculitis, glomerulonephritis, or immune complex-mediated disease is suspected
Normal Range
- Normal Result: Negative or undetectable cryoglobulins (typically reported as <1:20 titer or <0.80 mg/dL depending on laboratory method)
- Units of Measurement: Titer (reciprocal dilution), mg/dL (milligrams per deciliter), or percentage of serum
- Positive Result: Detected cryoglobulins at any detectable level (titer ≥1:20 or cryocrit ≥1%) indicates the presence of cold-precipitable immunoglobulins
- Interpretation of Normal: Absence of cryoglobulins suggests no cryoglobulinemia, though does not completely rule out the condition as cryoglobulins can be intermittently present
- Interpretation of Abnormal: Positive findings confirm cryoglobulinemia and warrant further characterization of immunoglobulin types and underlying cause
Interpretation
- Positive Cryoglobulins: Indicates presence of cold-precipitable immunoglobulins; further testing required to determine type and underlying etiology
- Type I Cryoglobulinemia: Monoclonal immunoglobulin (usually IgM or IgG); associated with lymphoproliferative disorders, multiple myeloma, or Waldenström macroglobulinemia
- Type II Cryoglobulinemia (Mixed Essential): Monoclonal IgM with rheumatoid factor activity and polyclonal IgG; strongly associated with Hepatitis C infection (most common form); can cause vasculitis and glomerulonephritis
- Type III Cryoglobulinemia (Mixed): Polyclonal IgM with rheumatoid factor activity and polyclonal IgG; associated with autoimmune diseases, chronic infections, and connective tissue disorders
- High Titers or High Cryocrit: Greater amount of cryoglobulins indicates more active disease and higher risk of clinical manifestations including vasculitis, renal involvement, and neuropathy
- Factors Affecting Results: Sample temperature during collection and transport (must be kept at 37°C); timing of sampling; recent infections or immune stimulation; antiretroviral therapy; interferon treatment
- Clinical Significance: Detection of cryoglobulins correlates with systemic manifestations; presence may predict risk of complications; used to guide treatment decisions and monitor disease progression
Associated Organs
- Primary Systems Affected: Blood vessels (vasculitis), skin, kidneys, nervous system, joints, and blood cells
- Renal Involvement: Membranoproliferative glomerulonephritis (MPGN) is common; immune complex deposition leads to proteinuria, hematuria, and progressive kidney disease; may require dialysis
- Dermatologic Manifestations: Palpable purpura (typically on lower extremities), skin ulceration, necrosis, and tissue damage from vasculitis
- Neurological Involvement: Peripheral neuropathy (sensory and/or motor); mononeuritis multiplex; central nervous system complications in severe cases
- Hepatic Involvement: Especially in HCV-associated cryoglobulinemia; cirrhosis and liver dysfunction; increased risk of hepatocellular carcinoma
- Musculoskeletal Involvement: Arthralgias and arthritis, particularly affecting small joints; myalgias and muscle pain
- Hematologic Involvement: Anemia, thrombocytopenia; risk of bleeding complications
- Associated Diseases: Hepatitis C virus infection (most common), Hepatitis B, lymphoproliferative disorders, systemic lupus erythematosus, rheumatoid arthritis, Sjögren's syndrome, primary biliary cirrhosis
Follow-up Tests
- Cryoglobulin Type Characterization: Immunofixation or immunophenotyping to determine Type I, II, or III; essential for determining etiology and prognosis
- Hepatitis C Serology: HCV antibody and HCV RNA testing (PCR) to confirm HCV infection in patients with positive cryoglobulins
- Rheumatoid Factor: Typically elevated in Type II and III cryoglobulinemia; helps with classification
- Complement Studies: C3 and C4 levels; low C4 is characteristic of cryoglobulinemia and indicates immune activation
- Renal Function Tests: Serum creatinine, blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), urinalysis with microscopy to detect proteinuria and hematuria
- Kidney Biopsy: May be indicated for patients with active glomerulonephritis to confirm MPGN and guide treatment
- Autoimmune Markers: ANA, anti-Ro/SSA, anti-La/SSB, anti-CCP if autoimmune disease is suspected
- Hepatitis B Testing: HBsAg and anti-HBc to rule out HBV-associated cryoglobulinemia
- Complete Blood Count (CBC): To assess for anemia, leukopenia, or thrombocytopenia
- Liver Function Tests: AST, ALT, alkaline phosphatase, bilirubin to assess for hepatic involvement
- Imaging Studies: Ultrasound or CT of abdomen to evaluate for cirrhosis, liver lesions, or splenomegaly in HCV patients
- Monitoring Frequency: Repeat cryoglobulin testing every 3-6 months in patients with active disease; baseline then annually for stable disease; more frequently if symptoms worsen
Fasting Required?
- Fasting Status: No fasting is required for cryoglobulins serum test
- Critical Specimen Handling: Blood collection must be performed with pre-warmed tubes and syringes maintained at body temperature (37°C/98.6°F); specimen must be immediately placed in a 37°C water bath; rapid transport to laboratory at warm temperature is essential to prevent false-negative results
- Special Patient Preparation: Patient should avoid cold exposure before blood draw; schedule draw when veins are accessible without tourniquet applied for extended periods; inform phlebotomist about cryoglobulin testing to ensure proper warm collection technique
- Medications: No need to withhold medications; continue all prescribed medications as normal unless otherwise directed by physician
- Important Note: Improper specimen collection (allowing cooling) is the leading cause of false-negative cryoglobulin tests; proper temperature control is more critical than fasting status

How our test process works!