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In informal clinical speech, a short form forcryoprecipitate.
To assist in identifying the presence of certain immunological disorders such as Reynaud’s phenomenon.
SpecimenSerum (1 mL) collected in a red-top tube.
(Method: Visual observation for changes in appearance) Negative.
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’s 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.
This procedure is contraindicated for
- Assist in diagnosis of neoplastic diseases, acute and chronic infections, and collagen diseases
- Detect cryoglobulinemia in patients with symptoms indicating or mimicking Raynaud’s disease
- Monitor course of collagen and rheumatic disorders
- Cryoglobulins are present in varying degrees in associated conditions.
- Chronic lymphocytic leukemia
- Multiple myeloma
- Autoimmune hepatitis
- Rheumatoid arthritis
- Sjögren’s syndrome
- Waldenström’s macroglobulinemia
- Acute poststreptococcal glomerulonephritis
- Chronic infection (especially hepatitis C)
- Infectious mononucleosis
- Polymyalgia rheumatica
- Rheumatoid arthritis
- Systemic lupus erythematosus
Type I cryoglobulin (monoclonal)
- Testing the sample prematurely (before total precipitation) may yield incorrect results.
- Failure to maintain sample at normal body temperature before centrifugation can affect results.
- A recent fatty meal can increase turbidity of the blood, decreasing visibility.
Nursing Implications and Procedure
- Positively identify the patient using at least two unique identifiers before providing care, treatment, or services.
- Patient Teaching: Inform the patient this test can assist in assessing for immune system disorders.
- Obtain a history of the patient’s complaints, including a list of known allergens, especially allergies or sensitivities to latex.
- Obtain a history of the patient’s immune system as well as results of previously performed laboratory tests and diagnostic and surgical procedures.
- Obtain a list of the patient’s current medications, including herbs, nutritional supplements, and nutraceuticals (see Effects of Natural Products on Laboratory Values).
- Review the procedure with the patient. Inform the patient that specimen collection takes approximately 5 to 10 min. Address concerns about pain and explain that there may be some discomfort during the venipuncture.
- Sensitivity to social and cultural issues, as well as concern for modesty, is important in providing psychological support before, during, and after the procedure.
- Note that there are no food, fluid, or medication restrictions unless by medical direction.
- Potential complications: N/A
- Avoid the use of equipment containing latex if the patient has a history of allergic reaction to latex.
- Instruct the patient to cooperate fully and to follow directions. Direct the patient to breathe normally and to avoid unnecessary movement.
- Observe standard precautions, and follow the general guidelines in Patient Preparation and Specimen Collection. Positively identify the patient, and label the appropriate specimen container with the corresponding patient demographics, initials of the person collecting the specimen, date, and time of collection. Perform a venipuncture.
- Remove the needle and apply direct pressure with dry gauze to stop bleeding. Observe/assess venipuncture site for bleeding or hematoma formation and secure gauze with adhesive bandage.
- Promptly transport the specimen to the laboratory for processing and analysis.
- Inform the patient that a report of the results will be made available to the requesting health-care provider (HCP), who will discuss the results with the patient.
- Reinforce information given by the patient’s HCP regarding further testing, treatment, or referral to another HCP. Answer any questions or address any concerns voiced by the patient or family.
- Depending on the results of this procedure, additional testing may be performed to evaluate or monitor progression of the disease process and determine the need for a change in therapy. Evaluate test results in relation to the patient’s symptoms and other tests performed.
- Related tests include ALT, ANA, arthroscopy, AST, bilirubin, biopsy liver, bone scan, ceruloplasmin, copper, CRP, ESR, GGT, infectious mono screen, hepatitis C antibody, IgA, IgG, IgM, IFE, liver and spleen scan, protein, protein electrophoresis, RF, synovial fluid analysis, and US liver.
- Refer to the Immune System table at the end of the book for related tests by body system.