Kallemuchikkal U, Gorevic P D
Department of Medicine, The Mount Sinai Medical Center, New York, NY 10029-6574, USA.
Arch Pathol Lab Med. 1999 Feb;123(2):119-25. doi: 10.5858/1999-123-0119-EOC.
Cryoglobulins are immunoglobulins that precipitate as serum is cooled below core body temperatures. A cryoglobulin screen is the observation of a serum specimen collected and separated while warm for cryoprecipitation over a period of up to 7 days. Values of the screening may be reported as a cryocrit, which is the volume percent of the precipitate compared with the total volume of serum. Further proof that the precipitate is indeed a cryoglobulin can be obtained by demonstrating resolubilization with warming and immunochemical analysis by immunofixation. Detailed characterization of cryoglobulins may also require rigorous washing of the precipitate, quantitation of total protein and immunoglobulins, and evaluation of serum for monoclonal gammopathy, rheumatoid factor activity, evidence of complement activation, and presence of hepatitis C virus seroreactivity or hepatitis C virus RNA. The single most important variable confounding standardization of cryoglobulin testing is the frequently improper separation of warm serum from other blood elements prior to screening and characterization.
冷球蛋白是在血清冷却至低于核心体温时沉淀的免疫球蛋白。冷球蛋白筛查是对采集的血清标本进行观察，该标本在温暖状态下收集并分离，然后在长达7天的时间内进行冷沉淀。筛查结果可以报告为冷球蛋白比容，即沉淀体积占血清总体积的百分比。通过证明加热后重新溶解以及免疫固定的免疫化学分析，可以进一步证实沉淀确实是冷球蛋白。冷球蛋白的详细特征描述可能还需要对沉淀进行严格洗涤、总蛋白和免疫球蛋白定量，以及评估血清中的单克隆丙种球蛋白病、类风湿因子活性、补体激活证据、丙型肝炎病毒血清反应性或丙型肝炎病毒RNA的存在情况。冷球蛋白检测标准化中最重要的单一变量混淆因素是在筛查和特征描述之前，温暖血清与其他血液成分的分离常常不当。
