Cryoglobulin, Qualitative, Serum With Quantitative Reflex

Cryoglobulin, Qualitative, Serum With Quantitative Reflex

Number
	001594
CPT
	82595
Test Includes
	Qualitative test for cryoglobulin; reflex quantitation (as percentage) and immunofixation of cryoprecipitate if positive
Special Instructions
	If reflex testing is performed, additional charges/CPT code(s) may apply.
Specimen
	Serum
Volume
	4 mL
Minimum Volume
	3 mL
Container
	Red-top tube or gel-barrier tube
Collection
	Specimen must be drawn in a prewarmed tube and kept at 37°C while clotting. Separate serum from cells immediately after clot formation (keep at 37°C while clotting) and transfer serum into a clean transport tube.
Storage Instructions
	Maintain specimen at room temperature.
Patient Preparation
	Patient should be fasting.
Causes for Rejection
	Specimen not allowed to clot at 37°C; patient not fasting; lipemia; frozen specimen received
Reference Interval
	None detected (positives are reported as percentages)
Use
	Cryoglobulins may be present in macroglobulinemia of Waldenström, myeloma, chronic lymphocytic leukemia, lupus, chronic active hepatitis, and other viral infections.
Methodology
	Visual observation of refrigerated samples
Additional Information
	These are proteins which precipitate from blood at low temperatures. A precipitate from serum which forms overnight at 4°C and dissolves at 37°C is called a cryoglobulin. Cryoglobulins may be divided into three classes. Type I are monoclonal immunoglobulins and are usually associated with lymphoproliferative disorders. Type II are mixtures of a monoclonal IgM and polyclonal IgG, and are associated with macroglobulinemia and chronic active hepatitis. Type III are mixtures of polyclonal IgM and polyclonal IgG. These are found in a wide variety of disorders. A high percentage of patients with cryoglobulinemia have clinical symptoms, and of these the most common are vascular (ie, purpura and digital necrosis). Raynaud phenomenon is also common. Patients with SLE who are rheumatoid factor negative but cryoglobulin positive are more likely to develop renal disease than those who are rheumatoid factor positive and cryoglobulin negative.