Cryoglobulins

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Item	Process
Specimen	10 mL blood collected in a plain tube, separated at 37°C and then transported to the laboratory.
Method	Serum is stored at 4°C for 72 hours and inspected for precipitate during this period. Precipitates are quantitated and evaluated for monoclonal, polyclonal and mixed immunoglobulin components. EPG should be carried out on redisolved cryoglobulin to detect any monoclonal components.
Application	Investigation of cold related symptoms, suspected immune complex mediated disease. The disorder should be considered in the presence of one or more of renal impairment, rash and peripheral neuropathy.
Interpretation	A cryoglobulin precipitates at 4°C and redissolves at 37°C. The presence of cryoglobulin may be secondary to an underlying infection (especially hepatitis C), lymphoma, myeloma or immune complex disorder (eg, Sjogren's Syndrome).
Reference	Ferri C et al. J Clin Pathol 2002; 55(1): 4-13.