Test Code Billings Clinic: 3027 Mayo: CRGSP Cryoglobulin and Cryofibrinogen Panel, Serum and Plasma
Reporting Name
Cryo Panel, S and PPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Useful For
Evaluating patients with vasculitis, glomerulonephritis, and lymphoproliferative diseases
Evaluating patients with macroglobulinemia or myeloma in whom symptoms occur with cold exposure
This test is not useful for general screening of a population without a clinical suspicion of cryoglobulinemia.
Method Name
CRY_S, CRY_P: Quantitation and Qualitative Typing Precipitation
IMFXC: Immunofixation
Specimen Required
Both plasma and serum are required.
Patient Preparation: Fasting: 12 hours, preferred but not required
Specimen Type: Plasma
Collection Container/Tube: Lavender top (EDTA)
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL Plasma
Collection Instructions:
1. Tube must remain at 37° C.
2. Centrifuge at 37° C. Do not use a refrigerated centrifuge. If absolutely necessary, ambient temperature is acceptable. It is very important that the specimen remains at 37° C until after separation of plasma from red blood cells.
3. Place plasma into an appropriately labeled plastic vial.
Specimen Type: Serum
Collection Container/Tube: Red top (serum gel/SST are not acceptable)
Submission Container/Tube: Plastic vial
Specimen Volume: 5 mL Serum
Collection Instructions:
1. Tube must remain at 37° C.
2. Allow blood to clot at 37° C.
3. Centrifuge at 37° C. Do not use a refrigerated centrifuge. If absolutely necessary, ambient temperature is acceptable. It is very important that the specimen remains at 37° C until after separation of serum from red blood cells.
4. Place serum into an appropriately labeled plastic vial.
Additional Information: Analysis cannot be performed with less than 3 mL of serum. Smaller volumes are insufficient to detect clinically important trace (mixed) cryoglobulins. Less than 3 mL will require collection and submission of a new specimen.
Specimen Type
Plasma EDTASerum Red
Specimen Minimum Volume
Plasma: 0.5 mL; Serum: 3 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Plasma EDTA | Refrigerated (preferred) | |
| Frozen | ||
| Serum Red | Refrigerated (preferred) | |
| Frozen | ||
Reject Due To
| Gross hemolysis | OK |
| Gross lipemia | OK |
| Gross icterus | OK |
Reference Values
CRYOGLOBULIN
Negative
Positive results are reported as a percentage or trace amount.
CRYOFIBRINOGEN
Negative
Interpretation
Type I cryoglobulins are composed of monoclonal protein, often linked to plasma cell disorders such as monoclonal gammopathy of undetermined significance, macroglobulinemia, or multiple myeloma.
Type II cryoglobulins have both monoclonal and polyclonal component and can be associated with associated with autoimmune disorders such as vasculitis, glomerulonephritis, systemic lupus erythematosus, rheumatoid arthritis, and Sjogren syndrome. It may be seen in infections such as hepatitis, infectious mononucleosis, cytomegalovirus, and toxoplasmosis.
Type III cryoglobulins consist of only polyclonal protein and are associated with the same diseases as type II cryoglobulins. Clinical severity depends more on thermal amplitude than concentration or type.
Cryofibrinogen precipitates in plasma only and is associated with vasculitis and thrombotic disorders.
Day(s) Performed
Monday through Friday
Report Available
2 to 10 daysTest Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
82585
82595
86334-Immunofixation (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| CRGSP | Cryo Panel, S and P | 74352-6 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 2685 | Cryofibrinogen, P | 11043-7 |
| 2684 | Cryoglobulin, S | 12201-0 |
Forms
If not ordering electronically, complete, print, and send a Benign Hematology Test Request Form (T755) with the specimen.
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| CRY_S | Cryoglobulin, S | Yes | Yes |
| CRY_P | Cryofibrinogen, P | No | Yes |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| IMFXC | Immunofixation Cryoglobulin | No | No |
Testing Algorithm
If cryoglobulin has a positive result after 1 or 7 days, then immunofixation will be performed at an additional charge. Immunofixation will only be performed once when positive cryoglobulin results are 0.1 mL of precipitate or greater.