Effective Monday, April 9, 2012, laboratory testing for cryoglobulins will no longer be performed in the University of Iowa Hospitals and Clinics Immunopathology laboratory. Instead, cryoglobulin testing will be available through two new mail-out test options in Epic:

"CRYOGLOBULIN QUANTITATION" [Epic # LAB1294]
"CRYOGLOBULIN QUANTITATION & REFLEX IFE TYPING" [Epic # LAB7635]

For both mail-out tests, if no cryoglobulins are present, the result will simply be "NEGATIVE". For "CRYOGLOBULIN QUANTITATION", if cryoglobulins are present, quantitative IgA, IgG, and IgM levels will be performed on the cryoprecipitant fraction. The total concentration of the immunoglobulins in the cryoprecipitant fraction correlates with the cryocrit (% cryoglobulins) currently reported by the Immunopathology Laboratory. Keep in mind that as with cryocrit, some patients may show disease symptoms at low immunoglobulin levels while other with higher levels are asymptomatic.

For "CRYOGLOBULIN QUANTITATION & REFLEX IFE TYPING", specimens positive for cryoglobulins will additionally get typing of the cryoglobulins by immunofixation electrophoresis (IFE). For example, type I cryoglobulinemia is composed of a monoclonal immunoglobulin. IFE typing can be helpful in initial characterization of the cryoglobulinemia but is typically not needed for following patients over time. IFE typing incurs additional charges.

Specimen should be collected in two pre-warmed red top tubes (no additives). The specimens must be kept at 37 degrees/body temperature (e.g., under arm) and delivered immediately to Specimen Control. Proper specimen collection and transport is critical for reliable cryoglobulin analysis. Specimen Control will accept specimens 24 hours/day, 7 days a week (including holidays). Typical turnaround time is 3-5 business days, although this can vary depending on how fast the cryoglobulins precipitate.

Questions should be directed to Matthew Krasowski, MD, PhD, medical director of the Clinical Chemistry Laboratory (384-9380, matthew-krasowski@uiowa.edu).