Cryoglobulinemia laboratory findings

Laboratory findings for cryoglobulinemia include hypocomplementemia, increased ESR, positive RF, leukocytosis, thrombocytosis and hematuria.

Tests for cryoglobulinemia include:^[1][2]

• Complete blood count (CBC)
• Complement assay — Numbers will be low (C4 levels)
  • Variable C3 levels

• Increased ESR

• Cryoglobulin test — may show presence of cryoglobulins
• Liver function tests — may be high
• Rheumatoid factor — positive in types II and III
• Urinalysis — may show blood in the urine if the kidneys are affected

• At least 20cc of blood should be drawn in the fasting state (lipids interfere) and sent to the lab in warm water.

  • The blood is spun at body temperature then the serum is cooled to see if a precipitate develops.

    • “Cryocrits” of up to 50% have been noted.

  • The cryoprecipitates is then analyzed for type of immune complex by immunofixation.
  • If anti-HCV and HCV RNA are negative but hepatits C is still suspected, the cryoprecipitate can be assayed directly for HCV RNA and anti-HCV antibody.^[3]
  • Spurious leukocytosis and thrombocytosis from the cryoglobulin particles have been noted if the sample is tested a lower temperature.
  • White blood cell count (WBC) of >40K normalize with warming of the blood.

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