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Coagulation

Coagulation laboratory tests

Cryoglobulin / cryofibrinogen assays


Reviewer: Jeremy Parsons, M.D. (see Reviewers page)
Revised: 20 June 2012, last major update June 2012
Copyright: (c) 2002-2012, PathologyOutlines.com, Inc.

General
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● Either asymptomatic or causes cutaneous symptoms at cold-exposed areas
● Cryofibrinogen consists of fibrinogen and other substances that precipitate at cold temperatures (cryoglobulins are immunoglobulins that precipitate at cold temperatures)
● Either primary, or associated with malignancy, infection (especially hepatitis C), inflammatory conditions, diabetes, pregnancy, oral contraceptives
● May exhibit leukocytoclastic vasculitis in skin biopsies

Specimen:
● Two sodium citrate or EDTA tubes plus one red top tube for cryoglobulin
● Place immediately in warm water (or use warmer for heal sticks or other warming method) and transport to laboratory within 2 hours
● Donít use heparin-containing specimens (heparin precipitates fibrinogen in this assay)

Indication:
● For patients with unexplained cutaneous ulcers or ischemia on cold-exposed areas

Procedure:
● Centrifuge at 37C, refrigerate plasma, centrifuge at 4C
● Each mm of visible precipitate represents 1% of cryofibrinogen
● Cyrocrit is %volume of precipitate compared to total plasma
● Also perform cryoglobulin test to ensure that plasma precipitate is not a cryoglobulin
● If the cryoglobulin test is positive, serum protein electorpheresis with immune fixation should be run to determine what type of cryoglobulin is present

End of Coagulation > Coagulation laboratory tests > Cryoglobulin / cryofibrinogen assays


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