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HelpTest Code Epic LAB3413 Cryoglobulin and Cryofibrinogen Panel, Serum and Plasma
Additional Codes
SUNQUEST PNEUMONIC - CRYOGM
Reporting Name
Cryo Panel, S and PUseful For
Evaluating patients with vasculitis, glomerulonephritis, and lymphoproliferative diseases
Evaluating patients with macroglobulinemia or myeloma in whom symptoms occur with cold exposure
This test is not useful for general screening of a population without a clinical suspicion of cryoglobulinemia.
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| CRY_S | Cryoglobulin, S | Yes | Yes |
| CRY_P | Cryofibrinogen, P | No | Yes |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| IMFXC | Immunofixation Cryoglobulin | No | No |
Testing Algorithm
If cryoglobulin has a positive result after 1 or 7 days, then immunofixation will be performed at an additional charge. Positive cryoglobulins of 0.1 mL or above of precipitate will be typed once.
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
Plasma EDTASerum Red
Specimen Required
Both plasma and serum are required.
Cryofibrinogen
Collection Container/Tube: Lavender top (EDTA)
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions:
1. Tube must remain at 37° C.
2. Centrifuge at 37° C. (Do not use a refrigerated centrifuge. If absolutely necessary, ambient temperature is acceptable.) It is very important that the specimen remain at 37° C until after separation of plasma from red blood cells.
3. Place plasma into an appropriately labeled plastic vial.
Cryoglobulin
Collection Container/Tube: Red top (serum gel/SST are not acceptable)
Submission Container/Tube: Plastic vial
Specimen Volume: 5 mL
Collection Instructions:
1. Tube must remain at 37° C.
2. Allow blood to clot at 37° C.
3. Centrifuge at 37° C. (Do not use a refrigerated centrifuge. If absolutely necessary, ambient temperature is acceptable.) It is very important that the specimen remain at 37° C until after separation of serum from red blood cells.
4. Place serum into an appropriately labeled plastic vial.
Additional Information: Analysis cannot be performed with less than 3 mL of serum. Smaller volumes are insufficient to detect clinically important trace (mixed) cryoglobulins. Less than 3 mL will require collection and submission a new specimen.
Specimen Minimum Volume
Plasma: 0.5 mL
Serum: 3 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Plasma EDTA | Refrigerated (preferred) | ||
| Frozen | |||
| Serum Red | Refrigerated (preferred) | ||
| Frozen | |||
Reference Values
CRYOGLOBULIN
Negative (positives reported as percent or trace amount)
If positive after 1 or 7 days, immunotyping of the cryoprecipitate is performed at an additional charge.
CRYOFIBRINOGEN
Negative
Quantitation and immunotyping will not be performed on positive cryofibrinogen.
Day(s) Performed
Monday through Friday
CPT Code Information
82585
82595
86334-Immunofixation (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| CRGSP | Cryo Panel, S and P | 74352-6 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 2685 | Cryofibrinogen, P | 11043-7 |
| 2684 | Cryoglobulin, S | 12201-0 |
Method Description
The normal proteins of plasma and serum do not precipitate in the cold. An aliquot of plasma and of serum are incubated for 24 hours at 1 degree C. If a precipitate develops in the serum, the specimen is centrifuged, and the percent precipitate is reported. Negative specimens are kept at 1 degree C for 7 days and rechecked. All positive cryoglobulins are analyzed by immunofixation to determine if the precipitate is a monoclonal protein, polyclonal protein, or a mixed cryoglobulin. Precipitates that occur in plasma and not serum are reported as positive for cryofibrinogen. Cryofibrinogen-positive specimens are not quantitated or immunotyped. Slowly forming fibrin clots (as may occur in hemophilia) are distinguished from cryoprecipitates by their inability to redissolve on warming.(Lerner AB, Watson CJ: Studies of cryoglobulins; unusual purpura associated with the presence of a high concentration of cryoglobulin [cold precipitable serum globulin]. Am J Med Sci. 1947 Oct;214[4]:410-415; Desbois AC, Cacoub P, Saadoun D: Cryoglobulinemia: An update in 2019. Joint Bone Spine. 2019 Nov;86(6):707-713. doi: 10.1016/j.jbspin.2019.01.016)
Report Available
2 to 10 daysReject Due To
| Gross hemolysis | OK |
| Gross lipemia | OK |
| Gross icterus | OK |
Method Name
CRY_S, CRY_P: Quantitation and Qualitative Typing Precipitation
IMFXC: Immunofixation
Forms
If not ordering electronically, complete, print, and send a Benign Hematology Test Request Form (T755) with the specimen.