Type of test Blood
Normal findings
No cryoglobulins detected
Test explanation and related physiology Cryoglobulins are abnormal globulin protein complexes that exist in the blood of patients with various diseases. These proteins precipitate reversibly at low temperatures and redissolve with rewarming. They can precipitate in the blood vessels of the fingers when exposed to cold temperatures. This precipitation causes sludging of the blood in those blood vessels. These patients may have symptoms of purpura, arthralgia, or Raynaud phenomenon.
Type I (monoclonal) cryoglobulinemia is associated with monoclonal gammopathy of undetermined significance, macroglobulinemia, or multiple myeloma. Type II (mixed, two or more immunoglobulins of which one is monoclonal) cryoglobulinemia is associated with autoimmune disorders, such as systemic lupus erythematosus, rheumatoid arthritis, and Sjögren syndrome. Type III (polyclonal) cryoglobulinemia is associated with the same disease spectrum as type II cryoglobulinemia.
Procedure and patient care
• See inside front cover for Routine Blood Testing.
• Fasting: verify with laboratory
• Blood tube commonly used: red
* Inform the patient that an 8-hour fast may be required.
* If cryoglobulins are found to be present, warn the patient to avoid cold temperatures and contact with cold objects to minimize Raynaud symptoms.
Abnormal findings
- Connective tissue disease (e.g., lupus erythematosus, Sjögren syndrome, rheumatoid arthritis)
- Lymphoid malignancies (e.g., multiple myeloma, leukemia, Waldenström macroglobulinemia, lymphoma)
- Acute and chronic infections (e.g., infectious mononucleosis, endocarditis, poststreptococcal glomerulonephritis)
- Liver disease (e.g., hepatitis, cirrhosis)
