Cryoglobulins

Also known as: CRYO

Cryoglobulins are immunoglobulins which form gels or precipitates when cooled and redissolve on warming. The indications for the detection of these include the investigation of suspected lymphoproliferative disease, immune complex and autoimmune disease. There is also strong association between Type II cryoglobulinaemia and Hepatitis C. The presence of a low C4 in conjunction with cutaneous vasculitis or renal disease is also an important clue to the potential presence of a cyroglobulin.

Type I - Monoclonal immunoglobulin only. Usually IgM, less commonly IgG or IgA due to polymerisation of the monoclonal paraprotein. May be associated with benign or malignant lymphoproliferative disease or myeloma.

Type II - Monoclonal IgM (usually IgM kappa) rheumatoid factor complexed with polyclonal IgG. May be associated with Hepatitis C or B infection. This disease may present with Raynaud's phenomenon, glomerulonephritis, cutaneous vasculitis, arthritis and sometimes other organ involvement.

Type III - Polyclonal IgM or IgG rheumatoid factors complexed with polyclonal IgG. This disorder may be a precursor to type II cryoglobulinaemia and is associated with a range of infective and autoimmune aetiologies.

Specimen requirements

2 separate 8 ml tubes of clotted blood.

These should be taken and immediately placed in a thermos flask containing water at 37 to 41°C. Arrange for rapid transport of the flask to Immunology at the Churchill via the specimen room on Level 4 (JR). Preferably, arrange for the patient to be bled in Phlebotomy at the Churchill.

Serum separated at 37°C can be sent via First Class Mail. It is the responsibility of the referring hospital to ensure that cryoglobulin sample is collected under the correct pre-analytical conditions prior to sending for analysis. This is paramount for those samples referred for immunotyping.

If there are any questions or doubts about taking blood for this test, contact Immunology: 01865 225995.

Cost

Price on application

Laboratory turnaround time

8 days; all new cryoglobulin positive samples will be typed leading to a delay in the quoted turnaround time

Laboratory method

Not applicable

Reference range/units

Positive or Negative

Associated tests

Not applicable

Sample stability

1 day kept and received at 35-41ºC

Shipping and storage

See specimen requirements.

Further information and contact details

For further information, email immunologylab.enquiries@ouh.nhs.uk