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Test Code CRY_S/80988 Cryoglobulin, Serum

Reporting Name

Cryoglobulin, S

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Useful For

Evaluating cryoglobulins in patients with vasculitis, glomerulonephritis, and lymphoproliferative diseases

 

Evaluating cryoglobulins in 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: Quantitation and Qualitative Typing Precipitation

IMFXC: Immunofixation


Ordering Guidance


This test is also available as a part of a profile to assess for both cryofibrinogen and cryoglobulin. For more information see CRGSP / Cryoglobulin and Cryofibrinogen Panel, Serum and Plasma.



Specimen Required


Patient Preparation: Fasting 12 hours, preferred but not required

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.


Billings Clinic Note:

Note 1. Send on heel warmer or specimen will be rejected.

Specimen Type

Serum Red

Specimen Minimum Volume

Serum: 3 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Red Refrigerated (preferred)
  Frozen 

Reject Due To

Gross hemolysis OK
Gross lipemia OK
Gross icterus OK

Reference Values

Negative

Positive results are reported as a percentage or trace amount.

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's 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.

Day(s) Performed

Monday through Friday

Report Available

2 to 10 days

Test 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

82595

86334-(if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CRY_S Cryoglobulin, S 12201-0

 

Result ID Test Result Name Result LOINC Value
2684 Cryoglobulin, S 12201-0

Forms

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-Kidney Transplant Test Request

-Renal Diagnostics Test Request (T830)

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
IMFXC Immunofixation Cryoglobulin No No

Testing Algorithm

If the cryoglobulin test 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.

 

For more information, see Acquired Neuropathy Diagnostic Algorithm.