title: Adequate sampling in cryoglobulinaemia: recommended warmly.
abstract: Propersample handling is important for the accurate and prompt diagnosis of cryoglobulinaemia as well as for obtaining correct results of other laboratory tests. In this case report, we present two patients for whom improper sampling delayed the diagnosis of cryoglobulinaemia. The routine sampling procedure was not sufficient for detecting these cryoglobulins and we demonstrated that the temperature dropped below 37 degrees C at different steps during the sample preparation. Adjusting the preanalytical procedure revealed that both patients possessed a cryoglobulin with high thermal insolubility. We conclude that in cryoglobulinaemia strict adherence to guidelines to keep the temperature >37 degrees C is crucial for sample collection and must be strongly recommended.
authors.affiliation: Department of Clinical Chemistry, Stichting Klinisch Chemisch Laboratorium, Leeuwarden, The Netherlands. a.j.bakker@kcl.znb.nl
authors.forename: Andries J
authors.initials: AJ
authors.lastname: Bakker
authors.forename: Jennichjen
authors.initials: J
authors.lastname: Slomp
authors.forename: Taede
authors.initials: T
authors.lastname: de Vries
authors.forename: Dick A G
authors.initials: DA
authors.lastname: Boymans
authors.forename: Bert
authors.initials: B
authors.lastname: Veldhuis
authors.forename: Kees
authors.initials: K
authors.lastname: Halma
authors.forename: Peter
authors.initials: P
authors.lastname: Joosten
mesh_terms: D019411:Clinical Laboratory Techniques; D003449:Cryoglobulinemia / Q000175:diagnosis* / Q000473:pathology; D003450:Cryoglobulins / Q000032:analysis*; D003951:Diagnostic Errors; D006801:Humans; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D013048:Specimen Handling; D013696:Temperature
chemical_list: D003450:Cryoglobulins