Summary
Accurate serum cryoglobulin detection is important to allow prompt treatment but laboratory
testing requires stringent pre-analytical conditions and has long turnaround times.
Serum protein electrophoresis (EPG) for paraproteinaemia and rheumatoid factor (RF)
analysis may offer an effective initial screening strategy for the presence of cryoglobulinaemia.
We retrospectively assessed the sensitivity of ancillary EPG and RF testing for the
presence of serum cryoglobulinaemia in 586 eligible cryoglobulin positive samples
received at the Royal Prince Alfred and Liverpool Hospital immunopathology laboratories
over an 11-year period. Ninety-one percent of all cryoglobulin positive samples had
either a detectable paraprotein or RF activity, with greatest sensitivity for type
I and type II cryoglobulins (97% and 98%, respectively). The sensitivity remained
high irrespective of whether EPG and RF analysis was performed with the same, or different,
pre-analytical collection conditions to the cryoglobulin collection (92% vs 90%, p=0.46). Only two patients with detected cryoglobulins and no associated paraprotein
or RF activity had clinical features of cryoglobulinaemia and neither required treatment.
This study demonstrates that serum EPG and RF analysis has high sensitivity for the
detection of clinically relevant cryoglobulinaemia, even when not collected under
ideal pre-analytical conditions, and potentially offers a prompt and effective screening
strategy.
Key words
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Article info
Publication history
Published online: December 06, 2022
Accepted:
September 6,
2022
Received in revised form:
August 5,
2022
Received:
April 22,
2022
Identification
Copyright
Crown Copyright © 2022 Published by Elsevier B.V. on behalf of Royal College of Pathologists of Australasia. All rights reserved.
