Chan Angel O K, Lau June S M, Chan C H, Shek C C
Department of Pathology, Queen Elizabeth Hospital, 30 Gascoigne Road, Hong Kong.
Hong Kong Med J. 2008 Feb;14(1):55-9.
Cryoglobulins are immunoglobulins that precipitate in the serum upon cooling to below core body temperature and re-dissolve at higher temperatures. Cryoglobulinaemia may be life-threatening. The three types of cryoglobulinaemia are associated with a wide spectrum of haematological, autoimmune, and chronic infectious diseases, especially hepatitis C infection. Our laboratory has received 378 requests for cryoglobulin testing over the past 5 years, with a detection rate of 4.8% in the 271 patients involved. Twelve per cent of the specimens were not processed due to being at an inappropriate temperature on arrival at the laboratory. Clinicians should be aware of temperature requirements when requesting cryoglobulin testing in suspected cases, and for all relevant protein tests in patients with cryoglobulinaemia. Handling specimens at inappropriate temperatures in the pre-analytical and analytical phases of the investigation might lead to cryoprecipitation and therefore false-negative results. The potential pitfalls encountered with specimen handling, analysis, and result interpretation are discussed in detail.
冷球蛋白是在冷却至低于核心体温时会在血清中沉淀并在较高温度下重新溶解的免疫球蛋白。冷球蛋白血症可能危及生命。三种类型的冷球蛋白血症与广泛的血液学、自身免疫性和慢性感染性疾病相关，尤其是丙型肝炎感染。在过去5年中，我们实验室收到了378份冷球蛋白检测请求，在所涉及的271例患者中的检出率为4.8%。12%的标本因到达实验室时温度不合适而未进行处理。临床医生在对疑似病例进行冷球蛋白检测以及对冷球蛋白血症患者进行所有相关蛋白质检测时应注意温度要求。在检测的分析前和分析阶段，在不合适的温度下处理标本可能会导致冷沉淀，从而产生假阴性结果。本文将详细讨论标本处理、分析和结果解释中可能遇到的潜在问题。
