Cryoglobulinemia laboratory findings
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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]
Overview
Laboratory Findings
Electrolyte and Biomarker Studies
Tests for cryoglobulinemia include:
- Complete blood count (CBC)
- Complement assay -- numbers will be low
- 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.
- 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.