Cryoglobulin, Qualitative, with Reflex to Quantitative IgA, IgG, and IgM

Label Mnemonic:	CRYO
Epic code:	LAB1294
Downtime form:	A-1a Doctor/Provider Orders - Pathology Core and Specialty Care Nursery

Commercial Mailout Laboratory
6240-8 RCP
356-8593

Specimen(s):

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:

	and
Red top tube 5 mL (Clot Activator)	and	Red top tube 5 mL (Clot Activator)

Minimum:

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.

Comments:

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".

Methodology:

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