Cryoglobulinemia laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2] Feham Tariq, MD [3]


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

Laboratory Findings

Electrolyte and Biomarker Studies

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.


  1. Gorevic PD, Kassab HJ, Levo Y, Kohn R, Meltzer M, Prose P, Franklin EC (August 1980). "Mixed cryoglobulinemia: clinical aspects and long-term follow-up of 40 patients". Am. J. Med. 69 (2): 287–308. PMID 6996482.
  2. Trendelenburg M, Schifferli JA (January 1998). "Cryoglobulins are not essential". Ann. Rheum. Dis. 57 (1): 3–5. PMC 1752454. PMID 9536813.
  3. Zaghloul H, El-Sherbiny W (January 2010). "Detection of occult hepatitis C and hepatitis B virus infections from peripheral blood mononuclear cells". Immunol. Invest. 39 (3): 284–91. doi:10.3109/08820131003605820. PMID 20380524.

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