The cryoglobulin test detects antibodies in the blood that may cause sensitivity to low temperatures. Cryoglobulins may be divided into three classes.

• Type I are monoclonal immunoglobulins, usually IgG or IgM, infrequently IgA, and are usually associated with lymphoproliferative disorders, especially macroglobulinemia or multiple myeloma. These are usually present in high concentrations.
• Type II cryoglobulins are mixed cryoglobulins consisting of two or more immunoglobulins of different classes, one being a monoclonal protein (with a high proportion being IgM), and the other a polyclonal IgG.
• Type III cryoglobulins are also mixed cryoglobulins consisting of two or more immunoglobulins of different classes, however, each component is a polyclonal immunoglobulin. These are usually present in low concentrations (<1%), and are associated with various autoimmune diseases, chronic active hepatitis, and other viral infections.

All types of cryoglobulins may be responsible for specific symptoms that occur in response to cold weather, such as Raynaud’s phenomenon, vascular purpura, bleeding tendencies, cold-induced urticaria, and even distal arterial thrombosis with gangrene.

Red serum vial/tube - 5 mL

1. Allow sample to clot in a 37°C incubator or water bath
2. Spin 
3. Immediately transfer serum to a False bottom plasma/serum transport vial/tube (AHL), labelled as serum
4. Maintain at room temperature after separation

False bottom plasma/serum transport vial/tube (AHL)

Gold serum separator (SST) tube

Immediately following collection, thoroughly mix sample by gently inverting 5 times

1. Allow sample to clot in a 37°C incubator or water bath for a minimum of 30 minutes
2. Spin 
3. Maintain at room temperature after separation

Ambient (Strict) - 7 days

Refrigerated - NO

Frozen - NO

• Samples not clotted in an incubator or water bath at 37°
• Improper labels (unlabeled or mislabeled)
• Hemolysis (some procedures)
• Lipemia
• Improper anticoagulant or ratio
• Delay in transport
• Improper storage temperature affecting results
• Improper container
• Leaking container resulting in compromised specimen
• Quantity not sufficient (QNS)

Precipitation

Negative