Cryoglobulin, Qualitative, with Reflex to Quantitative IgA, IgG, and IgM
Label Mnemonic: CRYO
Epic Lab Code: LAB1294
Downtime Form: A-1a Doctor/Provider Orders - Pathology Core and Specialty Care Nursery
Commercial Mail-out Laboratory
5231 RCP
Serum (in two pre-warmed tubes)
Specimen Instructions:
It is critical to keep specimen warm (37°C) during transport. Keep specimen at body temperature (e.g., under arm) and deliver immediately to Specimen Control. Spin within one hour of collection time.

Fasting specimen required.
Collection Medium:
Red top tube 5 mL (Clot Activator) Red top tube 5 mL (Clot Activator)
Preferred Minimum: 3 mL serum
Absolute Minimum: 1 mL serum

Proper collection and transport of specimen is critical to the outcome of the assay. Quantities less than 3 mL may affect the sensitivity of the assay.
Rejection Criteria:
Plasma. Serum separator tubes (SST or other clot-activating tubes). Grossly hemolyzed or lipemic specimens.
Turn Around Time:
3-5 days upon receipt at reference laboratory.
Reference Range:
Cryoglobulin, Qualitative - Negative at 72 hours.
Immunoglobulin A, Cryoprecipitate - None detected
Immunoglobulin G, Cryoprecipitate - None detected
Immunoglobulin M, Cryoprecipitate - None detected
Interpretive Data:
The sample is examined daily for the presence or absence of cryoglobulin.

Note: Cryoglobulins are usually associated with certain plasma cell and lymphoproliferative disorders, but have also been demonstrated in collagen vascular disease, hepatitis C infection, and infections such as infectious mononucleosis and cytomegalovirus disease.

If after three days cryoprecipitate is observed, then quantitative immunoglobulins (IgA, IgG, and IgM) will be added. Additional charges apply.
If IFE reflex is desired order test CRYTYP (LAB7635). Incubate unspun red top tubes at 37°C for 45 minutes, if clotted remove. If not clotted incubate for an additional 15 minutes at 37°C. Total incubation time is 1 hour (do not exceed). Spin at room temperature and aliquot 1.5 mL each into 2 aliquot tubes. Store and send room temperature. If only 1 red top received, continue with process and note "1 tube received".
Qualitative Cold Precipitation/Quantitative Nephelometry
CPT Code:
82595 Cryoglobulin; if reflexed for positive cryoglobulins, add 82784 x3 (IgA, IgG, IgM) for quantitative IgA, IgG, and IgM concentrations on the cryoprecipitate.
See Additional Information:
Fasting Specimen Requirements