Cryoglobulinemia laboratory findings: Difference between revisions
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{{Cryoglobulinemia}} | {{Cryoglobulinemia}} | ||
{{CMG}}; | {{CMG}}; {{AE}} {{CZ}} {{FT}} | ||
==Overview== | ==Overview== | ||
Laboratory findings for cryoglobulinemia include hypocomplementemia, increased ESR, positive RF, leukocytosis, thrombocytosis and hematuria. | |||
== Laboratory Findings == | ==Laboratory Findings== | ||
===Electrolyte and Biomarker Studies=== | |||
Tests for cryoglobulinemia include:<ref name="pmid6996482">{{cite journal |vauthors=Gorevic PD, Kassab HJ, Levo Y, Kohn R, Meltzer M, Prose P, Franklin EC |title=Mixed cryoglobulinemia: clinical aspects and long-term follow-up of 40 patients |journal=Am. J. Med. |volume=69 |issue=2 |pages=287–308 |date=August 1980 |pmid=6996482 |doi= |url=}}</ref><ref name="pmid9536813">{{cite journal |vauthors=Trendelenburg M, Schifferli JA |title=Cryoglobulins are not essential |journal=Ann. Rheum. Dis. |volume=57 |issue=1 |pages=3–5 |date=January 1998 |pmid=9536813 |pmc=1752454 |doi= |url=}}</ref> | |||
*Complete blood count (CBC) | |||
*Complement assay -- Numbers will be low (C4 levels) | |||
**Variable C3 levels | |||
* Increased ESR | |||
*Cryoglobulin test -- may show presence of cryoglobulins | |||
*Liver function tests -- may be high | |||
*[[Rheumatoid factor]] -- positive in types II and III | |||
*Urinalysis -- may show blood in the urine if the kidneys are affected | |||
* At least 20cc of blood should be drawn in the fasting state (lipids interfere) and sent to the lab in warm water. | * At least 20cc of blood should be drawn in the fasting state (lipids interfere) and sent to the lab in warm water. | ||
*:* The blood is spun at body temperature then the serum is cooled to see if a precipitate develops. | *:* The blood is spun at body temperature then the serum is cooled to see if a precipitate develops. | ||
*:*:* “Cryocrits” of up to 50% have been noted. | *:*:* “Cryocrits” of up to 50% have been noted. | ||
*:* The cryoprecipitates is then analyzed for type of immune complex by immunofixation. | *:* The cryoprecipitates is then analyzed for type of immune complex by immunofixation. | ||
*:* If anti-HCV and HCV RNA are negative but hepatits C is still suspected, the cryoprecipitate can be assayed directly for HCV RNA and anti-HCV antibody. | *:* If anti-HCV and HCV RNA are negative but hepatits C is still suspected, the cryoprecipitate can be assayed directly for HCV RNA and anti-HCV antibody.<ref name="pmid20380524">{{cite journal |vauthors=Zaghloul H, El-Sherbiny W |title=Detection of occult hepatitis C and hepatitis B virus infections from peripheral blood mononuclear cells |journal=Immunol. Invest. |volume=39 |issue=3 |pages=284–91 |date=January 2010 |pmid=20380524 |doi=10.3109/08820131003605820 |url=}}</ref> | ||
*:* Spurious leukocytosis and thrombocytosis from the cryoglobulin particles have been noted if the sample is tested a lower temperature. | *:* Spurious leukocytosis and thrombocytosis from the cryoglobulin particles have been noted if the sample is tested a lower temperature. | ||
*:* [[White blood cell]] count ([[WBC]]) of >40K normalize with warming of the blood. | *:* [[White blood cell]] count ([[WBC]]) of >40K normalize with warming of the blood. | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Hematology]] | [[Category:Hematology]] | ||
[[Category:Rheumatology]] | [[Category:Rheumatology]] | ||
[[Category:Blood tests]] | [[Category:Blood tests]] | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2] Feham Tariq, MD [3]
Overview
Laboratory findings for cryoglobulinemia include hypocomplementemia, increased ESR, positive RF, leukocytosis, thrombocytosis and hematuria.
Laboratory Findings
Electrolyte and Biomarker Studies
Tests for cryoglobulinemia include:[1][2]
- Complete blood count (CBC)
- Complement assay -- Numbers will be low (C4 levels)
- Variable C3 levels
- Increased ESR
- Cryoglobulin test -- may show presence of cryoglobulins
- Liver function tests -- may be high
- Rheumatoid factor -- positive in types II and III
- Urinalysis -- may show blood in the urine if the kidneys are affected
- At least 20cc of blood should be drawn in the fasting state (lipids interfere) and sent to the lab in warm water.
- The blood is spun at body temperature then the serum is cooled to see if a precipitate develops.
- “Cryocrits” of up to 50% have been noted.
- The cryoprecipitates is then analyzed for type of immune complex by immunofixation.
- If anti-HCV and HCV RNA are negative but hepatits C is still suspected, the cryoprecipitate can be assayed directly for HCV RNA and anti-HCV antibody.[3]
- Spurious leukocytosis and thrombocytosis from the cryoglobulin particles have been noted if the sample is tested a lower temperature.
- White blood cell count (WBC) of >40K normalize with warming of the blood.
- The blood is spun at body temperature then the serum is cooled to see if a precipitate develops.
References
- ↑ Gorevic PD, Kassab HJ, Levo Y, Kohn R, Meltzer M, Prose P, Franklin EC (August 1980). "Mixed cryoglobulinemia: clinical aspects and long-term follow-up of 40 patients". Am. J. Med. 69 (2): 287–308. PMID 6996482.
- ↑ Trendelenburg M, Schifferli JA (January 1998). "Cryoglobulins are not essential". Ann. Rheum. Dis. 57 (1): 3–5. PMC 1752454. PMID 9536813.
- ↑ Zaghloul H, El-Sherbiny W (January 2010). "Detection of occult hepatitis C and hepatitis B virus infections from peripheral blood mononuclear cells". Immunol. Invest. 39 (3): 284–91. doi:10.3109/08820131003605820. PMID 20380524.