Cryoglobulins
Cryoglobulins are antibodies that become solid or gel-like at low temperatures in the laboratory. This article describes the blood test used to check for them.
In the laboratory, cryoglobulins come out of solution in blood when the blood sample is cooled below 98.6°F (37°C). They dissolve again when the sample is warmed up.
Cryoglobulins come in three main types, but in most cases the cause of having cryoglobulins is hepatitis C. The disease in which cryoglobulins are found is called cryoglobulinemia. Cryoglobulins can cause inflammation in blood vessels, called vasculitis. They may also cause inflammation in the kidney, nerves, joints, lungs and skin.
Hepatitis C
Hepatitis C is a viral disease that leads to swelling (inflammation) of the liver. Other types of viral hepatitis include:Hepatitis AHepatitis BHepat...
Cryoglobulinemia
Cryoglobulinemia is the presence of abnormal proteins in the blood. These proteins thicken in cold temperatures.
How the Test is Performed
Because they are temperature sensitive, cryoglobulins are hard to accurately measure. The blood specimen must be collected in a special way. The test should only be done in laboratories that are equipped for it.
Blood is drawn from a vein. A vein on the inside of the elbow or the back of the hand is used in most cases. Blood should NOT be drawn from a catheter that has heparin in it. The site is cleaned with germ-killing medicine (antiseptic). The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood.
Next, the provider gently inserts a needle into the vein. The blood collects into an airtight vial or tube attached to the needle. The elastic band is removed from your arm. The vial should be warm at room or body temperature, before it is used. Vials that are colder than room temperature before being processed at the laboratory may not give accurate results.
Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.
How to Prepare for the Test
You may want to call ahead to ask to have your blood drawn by a lab technician who has experience collecting blood for this test.
How the Test will Feel
Some people feel discomfort when the needle is inserted. Afterward, there may be some throbbing.
Why the Test is Performed
This test is most often done when a person has symptoms of a condition associated with cryoglobulins. Cryoglobulins are associated with cryoglobulinemia. They also occur in other conditions that affect the skin, joints, kidneys, and nervous system.
Normal Results
Normally, there are no cryoglobulins.
Note: Normal value ranges may vary slightly among different laboratories. Talk to your provider about the meaning of your specific test results.
The example above shows the common measurement for results for these tests. Some laboratories use different measurements or may test different specimens.
What Abnormal Results Mean
A positive test may indicate:
- Cryoglobulinemia
- Hepatitis (especially hepatitis C)
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Infectious mononucleosis
Infectious mononucleosis
Mononucleosis, or mono, is a viral infection that causes fever, sore throat, and swollen lymph glands, most often in the neck.
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Lymphoma
Lymphoma
Hodgkin lymphoma is a cancer of lymph tissue. Lymph tissue is found in the lymph nodes, spleen, liver, bone marrow, and other sites.
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Macroglobulinemia -- primary
Macroglobulinemia -- primary
Waldenström macroglobulinemia (WM) is a cancer of the B lymphocytes (a type of white blood cell). WM is associated with the overproduction of protei...
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Multiple myeloma
Multiple myeloma
Multiple myeloma is a blood cancer that starts in the plasma cells in the bone marrow. Bone marrow is the soft, spongy tissue found inside most bone...
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Rheumatoid arthritis
Rheumatoid arthritis
Rheumatoid arthritis (RA) is a disease that leads to inflammation of the joints and surrounding tissues. It is a long-term disease. It can also aff...
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Systemic lupus erythematosus
Systemic lupus erythematosus
Systemic lupus erythematosus (SLE) is an autoimmune disease. In this disease, the immune system of the body mistakenly attacks healthy tissue. It c...
Additional conditions under which the test may be performed includes nephrotic syndrome.
Nephrotic syndrome
Nephrotic syndrome is a group of symptoms and abnormal test results that include protein in the urine, low blood protein levels in the blood, high ch...
Risks
Risks associated with having blood drawn are slight, but may include:
- Excessive bleeding
- Fainting or feeling lightheaded
- Hematoma (blood accumulating under the skin)
- Infection (a slight risk any time the skin is broken)
References
De Vita S, Gandolfo S, Quartuccio L. Cryoglobulinemia. In: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, eds. Rheumatology. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 171.
McPherson RA, Riley RS, Massey HD. Laboratory evaluation of immunoglobulin function and humoral immunity. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 47.
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Blood test - illustration
Blood is drawn from a vein (venipuncture), usually from the inside of the elbow or the back of the hand. A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. Preparation may vary depending on the specific test.
Blood test
illustration
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Cryoglobulinemia of the fingers - illustration
Cryoglobulinemia is caused by an abnormal protein that is occasionally found in the blood of people with multiple myeloma, leukemia, and certain forms of pneumonia. It causes blood to gel at low temperatures. In this picture, cryoglobulinemia has reduced blood flow in the fingers so much the fingers have turned dark. The black areas are gangrene resulting from lack of blood flow.
Cryoglobulinemia of the fingers
illustration
-
Blood test - illustration
Blood is drawn from a vein (venipuncture), usually from the inside of the elbow or the back of the hand. A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. Preparation may vary depending on the specific test.
Blood test
illustration
-
Cryoglobulinemia of the fingers - illustration
Cryoglobulinemia is caused by an abnormal protein that is occasionally found in the blood of people with multiple myeloma, leukemia, and certain forms of pneumonia. It causes blood to gel at low temperatures. In this picture, cryoglobulinemia has reduced blood flow in the fingers so much the fingers have turned dark. The black areas are gangrene resulting from lack of blood flow.
Cryoglobulinemia of the fingers
illustration
Review Date: 1/25/2023
Reviewed By: Neil J. Gonter, MD, Assistant Professor of Medicine, Columbia University, NY and private practice specializing in Rheumatology at Rheumatology Associates of North Jersey, Teaneck, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.