Cryoglobulin

Synonym/Acronym:
Cryo.

Rationale
To assist in identifying the presence of certain immunological disorders such as Reynaud phenomenon.

Patient Preparation
There are no food, fluid, activity, or medication restrictions unless by medical direction.

Normal Findings
(Method: Visual observation for changes in appearance) Negative.

Critical Findings and Potential Interventions
N/A

Overview

(Study type: Blood collected in a red-top tube; related body system: Immune system.) Cryoglobulins are abnormal serum proteins that cannot be detected by protein electrophoresis. Cryoglobulins cause vascular problems because they can precipitate in the blood vessels of the fingers when exposed to cold, causing Raynaud phenomenon. They are usually associated with immunological disease. The laboratory procedure to detect cryoglobulins is a two-step process. The serum sample is observed for cold precipitation after 72 hr of storage at 4°C. True cryoglobulins disappear on warming to room temperature, so in the second step of the procedure, the sample is rewarmed to confirm reversibility of the reaction.

Indications

  • Assist in diagnosis of neoplastic diseases, acute and chronic infections, and collagen diseases.
  • Detect cryoglobulinemia in patients with symptoms indicating or mimicking Raynaud disease.
  • Monitor course of collagen and rheumatic disorders.

Interfering Factors

Factors that may alter the results of the study

  • Testing the sample prematurely (before total precipitation) may yield incorrect results.
  • Failure to maintain sample at normal body temperature before centrifugation can affect results.

Other Considerations:

  • A recent fatty meal can increase turbidity of the blood, decreasing visibility.

Potential Medical Diagnosis: Clinical Significance of Results

Increased In:

Cryoglobulins are present in varying degrees in associated conditions.

    Type I cryoglobulin (monoclonal)
  • Chronic lymphocytic leukemia
  • Lymphoma
  • Multiple myeloma
  • Type II cryoglobulin (mixtures of monoclonal immunoglobulin [Ig] M and polyclonal IgG)
  • Autoimmune hepatitis
  • Rheumatoid arthritis
  • Sjögren syndrome
  • Waldenström macroglobulinemia
  • Type III cryoglobulin (mixtures of polyclonal IgM and IgG)
  • Acute poststreptococcal glomerulonephritis
  • Chronic infection (especially hepatitis C)
  • Cirrhosis
  • Endocarditis
  • Infectious mononucleosis
  • Polymyalgia rheumatica
  • Rheumatoid arthritis
  • Sarcoidosis
  • Systemic lupus erythematosus

Decreased In:
N/A

Nursing Implications

Before the Study: Planning and Implementation

Teaching the Patient What to Expect

  • Inform the patient this test can assist in assessing for immune system disorders.
  • Explain that a blood sample is needed for the test.

After the Study: Potential Nursing Actions

Followup Evaluation and Desired Outcomes

  • Acknowledges that additional testing may be performed in order to evaluate or monitor progression of the disease process and determine the need for a change in therapy.

Cryoglobulinis the Nursing Central Word of the day!