Cryoglobulin (CG) refers to a pathological protein that is insoluble in serum at 4 ° C, readily polymerizable at 30 ° C, and dissolves at 37 ° C. Cryoglobulin can be present in many clinical diseases. It binds complement to produce an inflammatory response similar to that caused by immune complexes.

Basic Information

Specialist classification: growth and development examination classification: blood examination

Applicable gender: whether men and women apply fasting: fasting

Analysis results:

Below normal:
Rare.

Normal value:
Serum cryoglobulin: 0-14 mg / L

Above normal:
Elevated CG is seen in cryoglobulinemia. Clinically, it can be divided into monoclonal type (type I), monoclonal mixed type (type II), and polyclonal mixed type (type III).

negative:

Positive:

Tips: In order to prevent or reduce the loss of cryoglobulin, the syringe and the test tube should be pre-warmed first, and then the blood sample should be placed at 37 ° C for 2 h to allow the blood to coagulate and then separate. Normal value

The Folin-Lowry method is <14 mg/L (<1.4 mg/dl).

Clinical significance

1, CG elevation is seen in cryoglobulinemia. Clinically, it can be divided into monoclonal type (type I), monoclonal mixed type (type II), and polyclonal mixed type (type III).

2, type I cryoglobulinemia often occurs in multiple myeloma, Waldenstron macroglobulinemia, lymphoma and so on. Generally, symptoms are manifested only in the late stage of the disease when the cryoglobulin content reaches 5 to 30 g/L. Clinically occurring Raynaud's phenomenon, thrombosis, ulcers, gangrene, etc., are the result of high viscosity and fouling caused by the presence of cryoglobulin deposits in the blood vessels.

3, type II cryoglobulinemia mainly found in chronic lymphocytic leukemia, lymphoma, Sjogren syndrome and rheumatoid arthritis, sometimes seen in multiple bone marrow and macroglobulinemia. Its clinical manifestations such as vasculitis, vascular purpura, glomerulonephritis and immune complexes are associated with an increase in type II cryoglobulin.

4, type III is specific to 30%, can also be found in SLE, Sjogren syndrome, rheumatoid arthritis, hemolytic anemia, lymphoma and a variety of infections (such as syphilis, leprosy, trypanosomiasis, subacute bacteria Endocarditis, nephritis after streptococcal infection, infectious mononucleosis, etc.). Its clinical manifestations are also related to the inflammatory effects caused by immune complexes.

5, a large number of cryoglobulin increased in cryoglobulinemia, multiple myeloma.

6, a small amount of cryoglobulin increased in chronic lymphocytic leukemia, kala-azar, renal insufficiency, systemic lupus erythematosus, rheumatic fever, bacterial endocarditis, lymphosarcoma, malaria, nodular polyarteritis.

High results may be diseases: acute infection of the elderly after nephritis, macroglobulinemia, cryoglobulinemia, renal damage, primary mixed cryoglobulinemia vasculitis considerations

In order to prevent or reduce the loss of cryoglobulin, the syringe and the test tube should be pre-warmed first, and then the blood sample is placed at 37 ° C for 2 h to allow the blood to coagulate and then separate.

Inspection process

Determination of cryoglobulin and/or cold fibrinogen:

The presence or absence of cryoprecipitate can be identified using a Winner tube. The cryoglobulin was measured by adding serum to a Wen's tube and maintaining it at 37 ° C. For the determination of cryoglobulin and cold fibrinogen, another Wen's tube was filled with EDTA anticoagulated plasma, which was also maintained at 37 °C.

Type I monoclonal cryoglobulin and cold fibrinogen can be precipitated within 3 to 18 hours at 4 ° C, and mixed cryoglobulin (type I or type III) often takes more than 72 hours. The precipitate may be in the form of a floc, a gel or a crystal.

Cryoglobulin and cold fibrinogen can be redissolved at 37 °C. The precipitate did not dissolve at 37 ° C and could not be included in the assay. The quantitative determination of the cryoprecipitate can be carried out using a low temperature precipitate specific volume or using a biuret method to determine the concentration of the washed precipitate protein.

Identification of cryoprecipitate:

The precipitate from which the supernatant was discarded by centrifugation was centrifuged three times with 0.9% sodium chloride and resuspended three times. Finally, the precipitate was dissolved in 0.9% warm sodium chloride solution or buffer solution. Immunoprecipitation electrophoresis, identification of precipitate components using specific antiserum such as anti-human serum, anti-Ig/κ, anti-Ig/λ, anti-Ig/α-chain, anti-Ig/μ chain and anti-Ig/γ-chain . One lane was left without antisera and was used as a sample blank to ensure that no precipitation of proteins occurred at the spot of the cold gel.

Note: In order to prevent or reduce the loss of cryoglobulin, the syringe and the test tube should be pre-warmed first, and then the blood sample should be placed at 37 ° C for 2 h to allow the blood to coagulate and then separate.

Not suitable for the crowd

no.

Adverse reactions and risks

no.